Sample records for vulva sparganosis misdiagnosed

  1. Vulva Fibroadenoma Associated with Lactating Adenoma in a 26-Year-Old Nigerian Female

    PubMed Central

    Anunobi, C. C.; Obiajulu, F. J. N.; Banjo, A. A. F.; Okonkwo, A. O. E.

    2013-01-01

    Background. Vulva lactating adenoma is rare and may be misdiagnosed as adenocarcinoma in frozen section and aspiration cytology if breast tissue is not anticipated. Objective. To raise the awareness of lactating vulva ectopic breast lesion among clinicians and pathologists. Case Report. We present a case of vulva fibroadenoma associated with lactating adenoma in a 26-year-old Nigerian female. Conclusion. The rarity of vulva ectopic breast tissue can present a diagnostic challenge for both the clinician and the anatomical pathologist. Once excisional biopsy is done and the lesion confirmed histologically, the anxious patient can be reassured. PMID:24062962

  2. Human sparganosis in Thailand: an overview.

    PubMed

    Anantaphruti, Malinee T; Nawa, Yukifumi; Vanvanitchai, Yuvadee

    2011-06-01

    Human sparganosis is caused by cestode larvae (spargana) of the genus Spirometra, which exploit copepods as the first intermediate host. A wide range of amphibians, reptiles, birds, and mammals serve as second intermediate/paratenic hosts. Human infections occur mainly by ingesting raw intermediate/paratenic hosts. Cases are found mainly in China, Japan and Korea, and sporadically also in Thailand and other Asian countries. In the period 1943-2010, there were 52 reported cases of sparganosis in Thailand. The average patient age was 32 years (range 11-82 years). From the available patient information, the prevalence of sparganosis infection was higher among females than males, at a ratio of F:M=2:1 (27:15). Patients have mainly been found in the northeast, north, and central regions of Thailand, with only a few in the south. Although a single subcutaneous nodular lesion was the most common feature, about one third of patients had ocular lesions. In particular, patients having ocular lesions were about half of total cases reported pre-1990, with several confirmed cases' applying fresh frog muscle as a poultice to relieve sore eyes, according to traditional medicine. In Thailand, sparganosis is not merely a food-borne disease but is also caused by the traditional belief of applying frog muscles (contaminated with sparganum) to sore eyes. PMID:21459073

  3. Nichtmaligne Hauterkrankungen der Vulva

    Microsoft Academic Search

    R. Kürzl

    2009-01-01

    Zusammenfassung  Nichtmaligne Hautveränderungen sind die häufigste Ursache für Pruritus vulvae, Brennen und Wundsein. Der Lichen sclerosus\\u000a hat bei weitem die höchste Prävalenz und deshalb sollte er von Frauenärzten kompetent diagnostiziert und behandelt werden\\u000a können. Dies bedeutet insbesondere die Abkehr von der völlig sinn- und nutzlosen lokalen Östrogenanwendung an der Vulva (niemand\\u000a käme auf die Idee, den Lichen sclerosus beim Mann mit

  4. Intramuscular Sparganosis in the Gastrocnemius Muscle: A Case Report

    PubMed Central

    Kim, Jeung Il; Kim, Tae Wan; Hong, Sung Min; Moon, Tae Yong; Lee, In Sook; Choi, Kyung Un

    2014-01-01

    Sparganosis is a parasitic infection caused by the plerocercoid tapeworm larva of the genus Spirometra. Although the destination of the larva is often a tissue or muscle in the chest, abdominal wall, extremities, eyes, brain, urinary tract, spinal canal, and scrotum, intramuscular sparganosis is uncommon and therefore is difficult to distinguish from a soft tissue tumor. We report a case of intramuscular sparganosis involving the gastrocnemius muscle in an elderly patient who was diagnosed using ultrasonography and MRI and treated by surgical excision. At approximately 1 cm near the schwannoma at the right distal sciatic nerve, several spargana worms were detected and removed. PMID:24623885

  5. [Human plerocercoidosis and sparganosis: I. A historical review on aetiology].

    PubMed

    Qiu, Ming-hua; Qiu, Ming-de

    2009-02-28

    Plerocercoid should not be confused with Sparganum. The scolex of plerocercoid has a bothrium or bothrial slit but there is no true scolex in sparganum. Plerocercoid is a developmental stage of an animal tapeworm, genus Spirometra. Sparganum is another generic name of a pseudophyllidean cestode. Plerocercoid causes benign plerocercoidosis and sparganum causes "malignant sparganosis". Plerocercoidosis is a parasitic zoonosis which can be food-borne, water-borne, contact-borne or mother-borne. During the past 20 years, there has been significant progress in studies of human plerocercoidosis and sparganosis, especially the former. Spirometra erinacei-europiea plerocercoidosis and sparganosis prolifera distributed mainly in East Asia. Spirometra mansonoides plerocercoidosis has been reported from the USA. Up to the present, approximately 1400 cases of plerocercoidosis were reported from China, Japan, Korea, USA and Thailand, and at least 16 well-documented cases of human proliferating sparganosis were reported worldwide (in Japan, China, Thailand, USA, Paraguay, Venezuela, and the Philippines). The life cycle of Sparganum is unknown. For plerocercoid, human being acts as a dead-end hosts, copepod and frogs serve as intermediate hosts, and snakes and carnivorous animals are its paratenic hosts. This review summarizes the research progress on aetiology and pathogenesis of human plerocercoidosis and sparganosis. The second part (in press) will be concentrated on their pathology, clinical manifestations, diagnosis, treatment, epidemiology, control and prevention. PMID:19459502

  6. Solitary Mastocytoma of the Vulva

    PubMed Central

    Velusamy, Shasi; Karuthedath Areeppurath Mana, Jayasree; Mathew, Chalissery Francis

    2014-01-01

    Solitary mastocytoma of the skin is a rare tumor. Its occurrence in the vulva is extremely rare with only few case reports in the literature. We report a solitary mastocytoma of the vulva in a 10-year-old girl. Her systemic examination was unremarkable. The clinical and histopathological features were consistent with the diagnosis of solitary mastocytoma of the vulva. The follow-up after surgical excision was uneventful. The purpose of this communication is (i) to report a case of solitary mastocytoma occurring in an unusual site, the vulva and to show that (ii) in this case age at presentation is 10 years with infancy as common age of presentation of solitary mastocytoma, and to show that (iii) in appropriate setting this should be included in the differential diagnosis of vulval swelling. PMID:24800094

  7. Solitary mastocytoma of the vulva.

    PubMed

    Velusamy, Shasi; Karuthedath Areeppurath Mana, Jayasree; Mathew, Chalissery Francis

    2014-01-01

    Solitary mastocytoma of the skin is a rare tumor. Its occurrence in the vulva is extremely rare with only few case reports in the literature. We report a solitary mastocytoma of the vulva in a 10-year-old girl. Her systemic examination was unremarkable. The clinical and histopathological features were consistent with the diagnosis of solitary mastocytoma of the vulva. The follow-up after surgical excision was uneventful. The purpose of this communication is (i) to report a case of solitary mastocytoma occurring in an unusual site, the vulva and to show that (ii) in this case age at presentation is 10 years with infancy as common age of presentation of solitary mastocytoma, and to show that (iii) in appropriate setting this should be included in the differential diagnosis of vulval swelling. PMID:24800094

  8. Pruritus vulvae in prepubertal children

    Microsoft Academic Search

    Sandra C. Paek; Diane F. Merritt; Susan B. Mallory

    2001-01-01

    Background: Vulvar pruritus is a common complaint in females of all ages. However, little has been published on pruritus vulvae in children as a primary symptom. Objective: Our purpose is to review the causes and treatments of vulvar pruritus in prepubertal girls and to retrospectively evaluate the causes and outcomes of the premenarchal children we studied. Methods: The records of

  9. Skin diseases affecting the vulva

    Microsoft Academic Search

    Alena Salim; Fenella Wojnarowska

    2002-01-01

    Skin diseases of the vulva are associated with considerable morbidity and often reluctance on the part of patients to seek medical attention. The most common conditions seen in a dermatology vulval clinic are the vulval dermatoses (inflammatory disorders), which comprise lichen sclerosus, lichen planus, vulval eczema and psoriasis. Other conditions such as vulval pain syndromes, vulval disorders associated with systemic

  10. Prevalence of sparganosis by county of origin in florida feral swine

    Microsoft Academic Search

    Steven D Bengtson; Fretorry Rogers

    2001-01-01

    Sparganosis is a parasitic infection in amphibians, reptiles and mammals including feral swine and man. It is caused by migration of the metacestode (spargana) of Spirometra. The primary objective of this study was the determination of the prevalence of gross sparganosis in Florida county of origin in slaughtered feral swine. Tracebacks to county of origin were conducted for Florida feral

  11. [Lipedema: a misdiagnosed entity].

    PubMed

    Vignes, S

    2012-07-01

    Lipedema is a clinical entity frequently misdiagnosed or confound with primary lymphedema. Lipedema is a disorder of adipose tissue that occurs almost exclusively in obese women. It is characterized by bilateral enlargement from hip to ankle due to abnormal depositions of subcutaneous fat associated with often mild edema, usually sparing the feet. Disease onset is usually at or soon after puberty. Lipedema results in considerable frustration and distress resulting from the cosmetic appearance. Patients may complain of pain, tenderness, easy bruising of the affected areas with moderate to severe sensitivity to digital pressure or pinching. Imaging studies using computed tomography, magnetic resonance imaging, ultrasound, lymphoscintigraphy are not indicated, except if the diagnosis is atypic or doubtful. Long-term evolution may alter lymphatic system and lead to a lipo-lymphedema with specific complications such as cellulitis. Lipedema management is not codified and included weight loss (poorly improving leg appearance or discomfort), psychological counselling and compression therapy. Liposuction, especially using tumescent local anaesthesia, may reduce edema, spontaneous pain, sensitivity to pressure, bruising and improve appearance resulting in a important increase in quality of life. PMID:22698628

  12. Cerebral sparganosis: case report and review of the European cases.

    PubMed

    Lo Presti, Anna; Aguirre, Daniel T; De Andrés, Pablo; Daoud, Lina; Fortes, José; Muñiz, Jesús

    2015-09-01

    Sparganosis is a severe parasitic infection caused by the larvae of Spirometra mansoni, also called "sparganum." In human hosts, the Spirometra mansoni larva commonly targets the subcutaneous tissue or muscle. Sometimes it can also migrate into the brain, resulting in cerebral sparganosis, mainly characterized by focal neurological symptoms such as seizures and radiological "wandering lesions" on magnetic resonance images (MRIs). Clinical cases of cerebral sparganosis have been reported worldwide, mainly in Asian countries, but also in North America, South America and Australia. Only two cases have been previously reported in Europe. A 29-year-old male from Bolivia, who lived in Spain, presented to our service for seizures and a multicystic brain lesion, initially suspected to be a dysembryoplastic neuroepithelial tumor (DNET). He underwent gross total resection of the mixed solid/cystic lesion. Pathology revealed gliosis, multiple interconnected cystic cavities with fibrous walls, inflammatory cell infiltration and no necrotizing granulomatous reaction. Inside the cavities, a parasitic form was identified as the larva of the cestode Spirometra mansoni. At 1-year follow-up, the patient had no deficits and was seizure free. Clinicians should be alerted to the possible existence of this rare entity in Europe, especially in patients from endemic areas with a possible infection history as well as "wandering lesions" on the MRI. PMID:26085111

  13. Axillary sparganosis which was misunderstood lymph node metastasis during neoadjuvant chemotheraphy in a breast cancer patient.

    PubMed

    Lee, Eun Kyoung; Yoo, Young Bum

    2014-12-01

    Sparganosis of the breast is an uncommon disease, but should be considered in the differential diagnosis of unusual and suspicious breast masses. A history of ingesting contaminated water and direct ingestion of snakes and frogs may help in differential diagnosis of the mass. Complete surgical removal is the treatment of choice and provides a definite diagnosis. We report a case of multiple axillary lymph node sparganosis. It was first considered as an axillary metastasis of breast cancer because a newly axillary mass appeared in follow-up radiologic study after neoadjuvant chemotherapy. We performed curative breast cancer surgery and sparganosis was confirmed by extracting the worm during axillary dissection. PMID:25485243

  14. Myxoid Epithelial Leiomyoma of the Vulva: A Case Report and Literature Review

    PubMed Central

    Zhao, Ting; Liu, Xishi; Lu, Yuan

    2015-01-01

    Leiomyoma of vulva is rare, and usually misdiagnosed clinically as Bartholin cyst. It usually presents spindle-shaped tumor cells, but some rare cases consisted mainly of atypical epithelioid tumor cells. We report here a case of 30-year-old woman consulting with a vulvar mass of 7?cm in the Bartholin glands area. The lesion was surgically excised with its capsule completely. Pathological examination and immunochemistry showed characteristic of epithelioid leiomyoma with myxoid stroma with both estrogen receptor (ER) and progesterone receptor (PR) staining negative, which was really rare as only 2 cases of vulvar leiomyoma with both ER and PR were reported before. PMID:26185695

  15. Prevalence of sparganosis by county of origin in Florida feral swine.

    PubMed

    Bengtson, S D; Rogers, F

    2001-06-12

    Sparganosis is a parasitic infection in amphibians, reptiles and mammals including feral swine and man. It is caused by migration of the metacestode (spargana) of Spirometra. The primary objective of this study was the determination of the prevalence of gross sparganosis in Florida county of origin in slaughtered feral swine. Tracebacks to county of origin were conducted for Florida feral swine with and without gross sparganosis. Feral swine trapped in Florida and presented for slaughter in a Texas slaughter establishment from May to December 1999 was the sample population. Overall prevalence of sparganosis in Florida feral swine was 6.9%. Because Highlands county had the same prevalence, other counties were compared to it. Sparganosis was detected in 17 Florida counties. Swine originating from Osceola or Hillsborough counties (4.3 and 1.8% prevalence, respectively) had lower prevalence of sparganosis than in Highlands, whereas those from Marion county (21.7% prevalence) had a higher prevalence. Transmission to humans may occur via consumption of infected feral swine, other species of secondary intermediate hosts or the primary intermediate hosts. PMID:11390076

  16. Surgery for Cancer of the Vulva (Vulvectomy)

    MedlinePLUS

    ... the vulva (vulvectomy) Pelvic exenteration Sex and pelvic radiation therapy Sex and chemotherapy Sex and hormone therapy Surgery for breast cancer can affect sexuality, too Summary table of how ...

  17. Development of a Rapid Diagnostic Kit That Uses an Immunochromatographic Device To Detect Antibodies in Human Sparganosis

    PubMed Central

    Nakamura, Takeshi; Intapan, Pewpan M.; Maleewong, Wanchai; Morishima, Yasuyuki; Sugiyama, Hiromu; Matsuoka, Hiroyuki; Kobayashi, Kaoru; Takayama, Katsuyoshi; Kobayashi, Yukuharu

    2014-01-01

    A diagnostic kit using an immunochromatographic device was developed to replace the time-consuming immunodiagnostic methods for human sparganosis. The kit was found to be faster and easier to use than an enzyme-linked immunosorbent assay (ELISA) and showed higher sensitivity and specificity. It will be useful for the laboratory diagnosis of hospitalized cases of sparganosis. PMID:24990912

  18. Misdiagnosed gastrinoma: A case report.

    PubMed

    Sun, Qi-Kai; Wang, Wei; Zhou, Hang-Cheng; Lv, Yang; Yu, Ji-Hai; Ma, Jin-Liang; Jia, Wei-Dong; Xu, Ge-Liang

    2014-06-01

    Gastrinoma is most commonly located in the gastrinoma triangle (comprising of the duodenum, pancreas and bile ducts) or in the adjacent lymph nodes. Due to the low mortality rate, it is often misdiagnosed as other diseases with similar clinical characteristics, such as a solid pseudopapillary tumor of the pancreas (SPTP). Therefore, the current study reports a rare case of gastrinoma located in the tail of the pancreas of a female patient under medical examination, who exhibited no clinical symptoms. The tumor, which was located in the body and tail of the pancreas, was successfully resected and the spleen was preserved. The outcome of surgery combined with the postoperative pathological examination resulted in the patient being misdiagnosed with a SPTP. During the consequent six-year follow-up period, low-density liver lesions and an intractable peptic ulcer gradually appeared. Finally, the patient diagnosis was confirmed as a malignant pancreatic neuroendocrine carcinoma with liver metastases. On June 1, 2011, a liver transplant was successfully performed and the patient has maintained a good overall condition. The underlying clinical and pathological factors that may have resulted in misdiagnosis are investigated in the present study. Through providing our preliminary clinical experiences and lessons, the aim of the present study was to focus the attention of clinicians on this type of cancer in order to improve its diagnosis and treatment. PMID:24932294

  19. [Malignant vascular tumors of the vulva].

    PubMed

    Chokoeva, A; Tchernev, G

    2015-01-01

    Due to the increased vascularity as well as the unique anatomical structure, vascular lesions, which occur in the female reproductive system are common observed and diverse by their morphology. The majority of them are benign, including vascular malformations, lesions due to vascular hyperplasia, tumors with significant vascular component and others. Malignant vascular tumors are rare in the area of the vulva accounting about 1% of all vulvar lesions with vascular origin. Kaposi sarcoma, epithelioid hemangioepithelioma and epithelioid angiosarcoma have been reported with vulvar localization. With a view to their rare incidence, nonspecific clinical manifestation and aggressive behavior associated with high mortality, we present the most common malignant tumors of vascular origin arising in the vulva, as we emphasize on their epidemiology and clinical features, differential diagnosis and therapeutic algorithms for this rare type of malignancies. PMID:25909132

  20. Malignant spiradenoma/cylindroma of the vulva.

    PubMed

    Emam, Eman E; Sawan, Ali S; Al-Tamimi, Soha R; Molah, Rihab M

    2012-11-01

    Malignant spiradenoma/cylindroma of the vulva is an extremely rare adnexal tumor. We report the clinicopathological features of a 58-year-old woman who presented with malignant spiradenoma/cylindroma originating in the vulva and metastasized to the inguinal lymph nodes. Surgical excision with adequate margins and lymph node dissection was performed. Sections from the case were stained with Periodic Acid Schiff stain before and after diastase. Immunohistochemical study of the case using antibodies to carcinoembryonic antigen (CEA), epithelial membrane antigen (EMA), cytokeratin5/6 (CK 5/6), p63, cytokeratin7 (CK 7), smooth muscle actin (SMA), and S100 were performed. Microscopic examination revealed that spiradenoma nodules were positive to EMA and CEA. However, the cylindroma lobules showed strong immunoreactivity to p63 and CK5/6, whereas both tumor components were negative to S100, SMA, and CK7. Malignant spiradenoma/cylindroma is a rare tumor with controversial histogenesis that should be considered in the differential diagnosis of primary adnexal carcinoma and secondary metastatic tumors in the vulva. Further studies on a wider cohort should be encouraged. PMID:23147883

  1. Nine human sparganosis cases in Thailand with molecular identification of causative parasite species.

    PubMed

    Boonyasiri, Adhiratha; Cheunsuchon, Pornsuk; Suputtamongkol, Yupin; Yamasaki, Hiroshi; Sanpool, Oranuch; Maleewong, Wanchai; Intapan, Pewpan M

    2014-08-01

    Human sparganosis is one of the neglected diseases but important food-borne parasitic zoonoses. The disease is caused by larvae (spargana) of diphyllobothriidean tapeworm. Here, we describe nine cases of human sparganosis, caused by Spirometra erinaceieuropaei in a hospital in Thailand during 2001-2012. Clinical characteristics, treatment, and outcome of cases were revealed. Diagnosis and identification of causative parasite species was made by histopathological investigations followed by a polymerase chain reaction-based molecular method using formalin-fixed paraffin embedded tissues. The DNA samples were extracted from tissues and a partial fragment of cytochrome c oxidase subunit 1 (cox1) gene was amplified for the detection of parasitic DNA. Infection could be prevented by increasing activities on health communication by responsible public health agencies. PMID:24842879

  2. Characterization of Spirometra erinaceieuropaei Plerocercoid Cysteine Protease and Potential Application for Serodiagnosis of Sparganosis

    PubMed Central

    Liu, Li Na; Wang, Zhong Quan; Zhang, Xi; Jiang, Peng; Qi, Xin; Liu, Ruo Dan; Zhang, Zi Fang; Cui, Jing

    2015-01-01

    Background Sparganosis is a neglected but important food-borne parasitic zoonosis. Clinical diagnosis of sparganosis is difficult because there are no specific manifestations. ELISA using plerocercoid crude or excretory–secretory (ES) antigens has high sensitivity but has cross-reactions with other helminthiases. The aim of this study was to characterize Spirometra erinaceieuropaei cysteine protease (SeCP) and to evaluate its potential application for serodiagnosis of sparganosis. Methodology/Principal Findings The full length SeCP gene was cloned, and recombinant SeCP (rSeCP) was expressed and purified. Western blotting showed that rSeCP was recognized by the serum of sparganum-infected mice, and anti-rSeCP serum recognized the native SeCP protein of plerocercoid crude or ES antigens. Expression of SeCP was observed at plerocercoid stages but not at the adult and egg stages. Immunolocalization identified SeCP in plerocercoid tegument and parenchymal tissue. The rSeCP had CP activity, and the optimum pH and temperature were 5.5 and 37°C, respectively. Enzymatic activity was significantly inhibited by E-64. rSeCP functions to degrade different proteins and the function was inhibited by anti-rSeCP serum and E-64. Immunization of mice with rSeCP induced Th2-predominant immune responses and anti-rSeCP antibodies had the potential capabilities to kill plerocercoids in an ADCC assay. The sensitivity of rSeCP-ELISA and ES antigen ELISA was 100% when performed on sera of patients with sparganosis. The specificity of rSeCP-ELISA and ES antigen ELISA was 98.22% (166/169) and 87.57% (148/169), respectively (P<0.05). Conclusions The rSeCP had the CP enzymatic activity and SeCP seems to be important for the survival of plerocercoids in host. The rSeCP is a potential diagnostic antigen for sparganosis. PMID:26046773

  3. Retrospective epidemiological analysis of sparganosis in mainland China from 1959 to 2012.

    PubMed

    Lu, G; Shi, D-Z; Lu, Y-J; Wu, L-X; Li, L-H; Rao, L-Y; Yin, F-F

    2014-12-01

    In this study, epidemiological factors of sparganosis cases reported in mainland China from 1959 to December 2012 were analysed. A total of 1061 valid cases were distributed throughout most of the provinces of mainland China, with most cases occurring in Southern and Eastern China. The average age of patients was 29 years (range 0-80 years). Modes of transmission to humans were via contact (54·6%), mainly by application of frog meat as a poultice, foodborne (33·8%), mainly through ingesting frogs or snakes, and waterborne (11·5%) through drinking raw water. The tissue/organs involved were subcutaneous/muscle (43·1%), eyes (31·0%), central nervous system (CNS) (17·9%), urogenital system (3·9%) and visceral organs (3·2%). Obvious differences existed in main risk factors for different areas. Close correlation was found between tissue/organs and risk factors. Main modes of transmission changed during the past decades, from contact (83·8% pre-1979) to foodborne (63·9% post-2000). The tissue/organs involved also changed at the same time. Cases involving eyes fell from 50·0% pre-1979 to 8·3% post-2000, and cases involving CNS increased from 0% pre-1979 to 47·8% post-2000. These results illustrate that China is one of the main epidemic countries of sparganosis in the world. Consumption of frog/snake meat was the main risk factor, although application of frog flesh as a poultice was the main risk factor before 2000. Sparganosis has become one of the neglected but important foodborne/waterborne parasitic diseases in mainland China. PMID:25372227

  4. Autoimmune Lymphoproliferative Syndrome Misdiagnosed as Hemophagocytic Lymphohistiocytosis

    PubMed Central

    Rudman Spergel, Amanda; Walkovich, Kelly; Price, Susan; Niemela, Julie E.; Wright, Dowain; Fleisher, Thomas A.

    2013-01-01

    Autoimmune lymphoproliferative syndrome (ALPS) is a rare inherited disorder of apoptosis, most commonly due to mutations in the FAS (TNFRSF6) gene. It presents with chronic lymphadenopathy, splenomegaly, and symptomatic multilineage cytopenias in an otherwise healthy child. Unfortunately, these clinical findings are also noted in other childhood lymphoproliferative conditions, such as leukemia, lymphoma, and hemophagocytic lymphohistiocytosis, which can confound the diagnosis. This report describes a 6-year-old girl with symptoms misdiagnosed as hemophagocytic lymphohistiocytosis and treated with chemotherapy before the recognition that her symptoms and laboratory values were consistent with a somatic FAS mutation leading to ALPS. This case should alert pediatricians to include ALPS in the differential diagnosis of a child with lymphadenopathy, splenomegaly, and cytopenias; obtain discriminating screening laboratory biomarkers, such as serum vitamin B-12 and ferritin levels; and, in the setting of a highly suspicious clinical scenario for ALPS, pursue testing for somatic FAS mutations when germ-line mutation testing is negative. PMID:24101757

  5. Giant fibroepithelial stromal polyp of the vulva: largest case reported

    PubMed Central

    2013-01-01

    Background Fibroepithelial stromal polyps are site-specific mesenchymal lesions that are commonly found in the vulvovaginal region in premenopausal females. These polyps usually are less than 5 cm in diameter and are most commonly identified during routine gynecological examination. Although the stromal polyp is benign, its differential diagnosis includes some malignant vulva lesions making it critical to ensure that an accurate pathologic diagnosis is made. Case We present a case of a 21 year old female with a giant fibroepithelial stromal polyp of the vulva. Upon review of the literature this is the largest reported fibroepithelial stromal polyp to date. Conclusion Fibroepithelial stromal polyps can grow as large as 390 grams and can be 18.5-cm in diameter. Microscopic evaluation of the polyp is critical in the exclusion of malignancy with this diagnosis. PMID:23842282

  6. Combined (11)C-methionine and 18F-FDG PET imaging in a case of cerebral sparganosis.

    PubMed

    Zeng, Tao; Ji, Zhong-You; Shi, Song-Sheng

    2012-12-01

    A 35-year-old man presented with right lower extremity numbness and weakness. CT demonstrated an irregular left parietal hypoattenuation with a punctuate calcification. MRI revealed a T1 low signal and T2 high signal lesion with extensive surrounding edema. Gadolinium-enhanced MRI showed an irregular enhancing lesion. F-FDG and C-methionine PET both demonstrated high uptake in the left parietal lesion. Lesion SUV was 7.5 for F-FDG and 3.0 for C-methionine. Surgical pathology demonstrated cerebral sparganosis. PMID:23154480

  7. Torsion of a Large Appendix Testis Misdiagnosed as Pyocele

    PubMed Central

    Meher, Susanta; Rath, Satyajit; Sharma, Rakesh; Sasmal, Prakash Kumar; Mishra, Tushar Subhadarshan

    2015-01-01

    Torsion of the appendix testis is not an uncommon cause of acute hemiscrotum. It is frequently misdiagnosed as acute epididymitis, orchitis, or torsion of testis. Though conservative management is the treatment of choice for this condition, prompt surgical intervention is warranted when testicular torsion is suspected. We report a case of torsion of a large appendix testis misdiagnosed as pyocele. Emergency exploration of it revealed a large appendix testis with torsion and early features of gangrene. After excision of the appendix testis, the wound was closed with an open drain. The patient had an uneventful and smooth postoperative recovery. PMID:25861514

  8. Pigmented Mammary Paget Disease Misdiagnosed as Malignant Melanoma

    PubMed Central

    Lee, Ji Hye; Kim, Tae Hyung; Kim, Soo-Chan; Kim, You Chan

    2014-01-01

    Pigmented mammary Paget disease is a very rare clinicopathologic variant of mammary Paget disease. Diagnosis is often difficult because its clinical and histological features are very similar to those of malignant melanoma. Herein, we report a case of pigmented mammary Paget disease misdiagnosed as malignant melanoma. PMID:25473229

  9. Congenital hernia of cord: an often misdiagnosed entity.

    PubMed

    Raju, Rubin; Satti, Mohamed; Lee, Quoc; Vettraino, Ivana

    2015-01-01

    Congenital hernia of the cord, also known as umbilical cord hernia, is an often misdiagnosed and under-reported entity, easily confused with a small omphalocele. It is different from postnatally diagnosed umbilical hernias and is believed to arise from persistent physiological mid-gut herniation. Its incidence is estimated to be 1 in 5000. Unlike an omphalocele, it is considered benign and is not linked with chromosomal anomalies. It has been loosely associated with intestinal anomalies, suggesting the need for a complete fetal anatomical ultrasound evaluation. We present a case of a fetal umbilical cord hernia diagnosed in a 28-year-old woman at 21 weeks gestation. The antenatal and intrapartum courses were uncomplicated. It was misdiagnosed postnatally as a small omphalocele, causing unwarranted anxiety in the parents. Increased awareness and knowledge of such an entity among health professionals is important to prevent unwarranted anxiety from misdiagnosis, and inadvertent bowel injury during cord clamping at delivery. PMID:25899514

  10. Protruding vulva mutants identify novel loci and Wnt signaling factors that function during Caenorhabditis elegans vulva development.

    PubMed

    Eisenmann, D M; Kim, S K

    2000-11-01

    The Caenorhabditis elegans vulva develops from the progeny of three vulval precursor cells (VPCs) induced to divide and differentiate by a signal from the somatic gonad. Evolutionarily conserved Ras and Notch extracellular signaling pathways are known to function during this process. To identify novel loci acting in vulval development, we carried out a genetic screen for mutants having a protruding-vulva (Pvl) mutant phenotype. Here we report the initial genetic characterization of several novel loci: bar-1, pvl-4, pvl-5, and pvl-6. In addition, on the basis of their Pvl phenotypes, we show that the previously identified genes lin-26, mom-3/mig-14, egl-18, and sem-4 also function during vulval development. Our characterization indicates that (1) pvl-4 and pvl-5 are required for generation/survival of the VPCs; (2) bar-1, mom-3/mig-14, egl-18, and sem-4 play a role in VPC fate specification; (3) lin-26 is required for proper VPC fate execution; and (4) pvl-6 acts during vulval morphogenesis. In addition, two of these genes, bar-1 and mom-3/mig-14, are known to function in processes regulated by Wnt signaling, suggesting that a Wnt signaling pathway is acting during vulval development. PMID:11063687

  11. Protruding vulva mutants identify novel loci and Wnt signaling factors that function during Caenorhabditis elegans vulva development.

    PubMed Central

    Eisenmann, D M; Kim, S K

    2000-01-01

    The Caenorhabditis elegans vulva develops from the progeny of three vulval precursor cells (VPCs) induced to divide and differentiate by a signal from the somatic gonad. Evolutionarily conserved Ras and Notch extracellular signaling pathways are known to function during this process. To identify novel loci acting in vulval development, we carried out a genetic screen for mutants having a protruding-vulva (Pvl) mutant phenotype. Here we report the initial genetic characterization of several novel loci: bar-1, pvl-4, pvl-5, and pvl-6. In addition, on the basis of their Pvl phenotypes, we show that the previously identified genes lin-26, mom-3/mig-14, egl-18, and sem-4 also function during vulval development. Our characterization indicates that (1) pvl-4 and pvl-5 are required for generation/survival of the VPCs; (2) bar-1, mom-3/mig-14, egl-18, and sem-4 play a role in VPC fate specification; (3) lin-26 is required for proper VPC fate execution; and (4) pvl-6 acts during vulval morphogenesis. In addition, two of these genes, bar-1 and mom-3/mig-14, are known to function in processes regulated by Wnt signaling, suggesting that a Wnt signaling pathway is acting during vulval development. PMID:11063687

  12. Lipomatous angiomyofibroblastoma of the vulva: diagnostic and histogenetic considerations.

    PubMed

    Magro, G; Salvatorelli, L; Angelico, G; Vecchio, G M; Caltabiano, R

    2014-12-01

    We report a rare case of angiomyofibroblastoma (AMFB) of the vulva, composed predominantly of a mature fatty component, representing approximately 60% of the entire tumour. The tumour, designated as "lipomatous AMFB", should be interpreted as the morphological result of an unbalanced bidirectional differentiation of the presumptive precursor stromal cell resident in the hormonally-responsive stroma of the lower genital tract, with the adipocytic component overwhelming the fibroblastic/myofibroblastic one. The close admixture of adipocytes with spindled/epithelioid cells of the conventional AMFB resulted, focally, in a pseudo-infiltrative growth pattern and pseudo-lipoblast-like appearance, raising problems in differential diagnosis, especially with well-differentiated lipoma-like liposarcoma and spindle cell liposarcoma. Awareness of the possibility that vulvo-vaginal AMFB may contain large amount of lipomatous component is crucial to avoid confusion with other bland-looking spindle cell tumours containing infiltrating fat. PMID:25845047

  13. Phyllodes tumor of the breast metastasizing to the vulva.

    PubMed

    Ajenifuja, Olusegun Kayode; Kolomeyevskaya, Nonna; Habib, Fadi; Odunsi, Adekunle; Lele, Shashikant

    2015-01-01

    Phyllodes tumors of the breast are rare breast tumors that resemble fibroadenoma. They are composed of two types of tissues: stromal and glandular tissues. Unlike fibroadenoma, they are commonly found in the third decade of life and they tend to grow more rapidly. Depending on the relative components of the cells and mitotic activity, they are classified into benign, borderline, and malignant. They are usually present as a lump in the breast. Phyllodes tumors are usually managed by wide excision. The excision should be wide enough to ensure a tumor-free margin. Recurrence rate is very high and most recurrences are usually local. Metastasis to the vulva has not been reported. PMID:25960902

  14. Capnocytophaga canimorsus sepsis misdiagnosed as plague--New Mexico, 1992.

    PubMed

    1993-02-01

    Since 1961, 200 human isolates of Capnocytophaga canimorsus--a gram-negative bacterium--have been sent to CDC for identification. Infections with this organism may result in a spectrum of manifestations ranging from self-limiting cellulitis to fatal septicemia; most fatal infections have occurred in persons with a history of asplenia, alcoholism, or hematologic malignancy. In most (77%) cases, infection is preceded by a bite or other exposure to dogs. This report summarizes the investigation by the New Mexico Health and Environment departments and CDC of a fatal case of C. canimorsus infection in a resident of New Mexico. This case was initially misdiagnosed as human plague. PMID:8429807

  15. Extrahepatic textiloma long misdiagnosed as calcified echinococcal cyst.

    PubMed

    Cattaneo, Federico; Graffeo, Massimo; Brunetti, Enrico

    2013-01-01

    Textiloma or gossypiboma is a retained surgical swab in the body after an operation and is a complication that can remain undetected for many years and may represent a diagnostic dilemma depending on its location. It may be confused with several focal lesions and an accurate history taking, combined with clinical and instrumental data, is key to suspecting the diagnosis. We report a case of abdominal textiloma that was initially misdiagnosed as echinococcal cyst and discuss the differential diagnosis based on sonographic features and the WHO-IWGE classification. PMID:23533840

  16. Extrahepatic Textiloma Long Misdiagnosed as Calcified Echinococcal Cyst

    PubMed Central

    Cattaneo, Federico; Graffeo, Massimo; Brunetti, Enrico

    2013-01-01

    Textiloma or gossypiboma is a retained surgical swab in the body after an operation and is a complication that can remain undetected for many years and may represent a diagnostic dilemma depending on its location. It may be confused with several focal lesions and an accurate history taking, combined with clinical and instrumental data, is key to suspecting the diagnosis. We report a case of abdominal textiloma that was initially misdiagnosed as echinococcal cyst and discuss the differential diagnosis based on sonographic features and the WHO-IWGE classification. PMID:23533840

  17. Cervical dermatomal zona misdiagnosed as ulnar nerve entrapment.

    PubMed

    ?alçini, Celal; Sunter, Gülin; Gumustas, Seyit Ali; Evrensel, Alper

    2015-01-01

    Herpes zoster is a secondary reactivation of primary contagious varicella-zoster virus in the dorsal root ganglia. While thoracic zona is common, cervical dermatomal zona is a rare segmental complication of herpes zoster and can be easily misdiagnosed as other diseases. This article describes a patient with initial neuralgia without dermatomal lesions that was treated as ulnar nerve entrapment syndrome until manifestation of herpetiform cutaneous lesions appeared. It is important that clinicians should be aware of the possibility of zoster infection when evaluating the onset of neuralgia in a dermatomal distribution in the upper limb, especially without rash. PMID:26032704

  18. The Endemic Mimic: Blastomycosis An Illness Often Misdiagnosed

    PubMed Central

    Bradsher, Robert W.

    2014-01-01

    One of the endemic fungi, Blastomyces dermatitidis, can cause epidemics of infection with multiple persons involved in a point source outbreak but more commonly causes sporadic cases of infection within the areas of endemicity. Blastomycosis can present as an acute pneumonia which is often misdiagnosed as acute pneumococcal pneumonia or the infection may present as a chronic pneumonia along with weight loss, night sweats, hemoptysis, and a lung mass suggesting tuberculosis or carcinoma of the lung. Extrapulmonary infection with B. dermatitidis is protean with many different manifestations. Most commonly, skin or subcutaneous lesions are found with either a verrucous or warty appearance or in an ulcerative form. Cases have been misidentified as keratoacanthoma, pyoderma gangrenosum, carcinoma, or as Weber-Christian panniculitis if there are nodular subcutaneous lesions. Essentially any site or organ can have lesions of disseminated blastomycosis. In our series, cases of laryngeal carcinoma, adrenal insufficiency, thyroid nodules, granulomatous hypercalcemia, abnormal mammograms thought to represent breast carcinoma, otitis media with cranial extension, immune thrombocytopenic purpura, and hemolytic anemia of unknown cause have been misdiagnosed and blastomycosis subsequently identified as the cause. This infection causes manifestations which mimic many other more commonly diagnosed conditions and must always be considered by clinicians practicing in the endemic region. PMID:25125734

  19. Paget Disease of the Vulva: Diagnosis by Immunohistochemistry

    PubMed Central

    Gonçalves Amorim, Andressa; Batista Fraga Mendes, Brunelle; Neves Ferreira, Rodrigo; Chambô Filho, Antônio

    2015-01-01

    The objective of this paper is to report a case of extramammary Paget disease of the vulva, to describe its diagnosis, surgical treatment, and outcome, and to discuss the general characteristics of this pathology. This is a rare neoplasm, found principally in areas in which apocrine and eccrine glands are numerous. This case report is relevant to the literature since the differential diagnosis of extramammary Paget disease is difficult to be done only with the macroscopic appearance of the lesion and even with the microscopic characteristics, requiring further studies, immunohistochemistry, as to differentiate pathologies. The present report describes the case of a 63-year-old patient at the Santa Casa de Misericórdia Hospital in Vitória, Espírito Santo, Brazil, who presented with a hardened, ulcerated, and purplish lesion with hyperchromic and hypochromic spots, measuring 4?cm in diameter, located on the lower third of right labium majus, close to the vaginal fourchette. A right hemivulvectomy was performed, leaving wide margins all around. The patient progressed satisfactorily following surgery. Although extramammary Paget disease is rare, its incidence increases as a function of the patient's age. Patients should be followed up closely because of the risk of persistence and/or recurrence of the disease. PMID:26060586

  20. Nodular Fasciitis of the Breast Previously Misdiagnosed as Breast Carcinoma

    PubMed Central

    Ozben, Volkan; Aydogan, Fatih; Karaca, Fatih Can; Ilvan, Sennur; Uras, Cihan

    2009-01-01

    Summary Background Nodular fasciitis of the breast is a rare benign pathology that can mimic breast cancer clinically, radiologically, and histopathologically. Case Report An 18-year-old female patient had first visited a physician in a different center with the complaint of a lump in her left breast. Breast examination had revealed a palpable mass located in the left upper outer quadrant. Ultrasonography had demonstrated a hypoechoic lesion. Excisional biopsy of the lump had been performed and histopathologic examination misdiagnosed this lump as a mesenchymal tumor. The patient was then referred to our clinic for further investigations. Pathologic revision was performed and the diagnosis of nodular fasciitis of the breast was established. Conclusion Awareness of this rare clinical entity, nodular fasciitis, in the breast eliminates the misdiagnosis of breast cancer. PMID:20877676

  1. A tumoriform lesion of the vulva with features of mammary-type fibrocystic disease.

    PubMed

    Konstantinova, Anastasia M; Kacerovska, Denisa; Michal, Michal; Kazakov, Dmitry V

    2013-10-01

    : Fibrocystic disease is a common benign lesion of the breast. Variably sized cysts, apocrine metaplasia, fibrosis, calcification, chronic inflammation, and epithelial hyperplasia are the basic morphological changes seen in mammary fibrocystic disease. We report a rare tumoriform lesion of the vulva with features of fibrocystic disease, which seems to be the first description of this condition in the vulva. The pertinent literature is discussed. The reported lesion further demonstrates the analogy between tumors of anogenital mammary-like glands and mammary neoplasms. PMID:23435363

  2. Keratocystic odontogenic tumour (KCOT) misdiagnosed as a dentigerous cyst

    PubMed Central

    Chaudhary, Seema; Sinha, Ashish; Barua, Pranamee; Mallikarjuna, Rachappa

    2013-01-01

    Keratocystic odontogenic tumours are known for their peculiar behaviour, varied origin, debated development, unique tendency to recur and disputed treatment modalities. Thus, it has been the subject of much research over the last 40?years. It was formerly known as odontogenic keratocyst (OKC). OKC received its new title as keratocystic odontogenic tumour (KCOT) by the WHO (2005) in order to suggest its aggressive and recurrent nature. KCOT is a benign intraosseous neoplasm of the jaw. Involvement of the maxillary sinus is an unusual presentation. We present the case of an 11-year-old child with extensive KCOT and an impacted canine in the right maxillary sinus. The cyst was initially misdiagnosed to be a dentigerous cyst based on the clinical and radiographic features though a differential diagnosis of KCOT and adenomatoid odontogenic tumour was made. The histological examination of the specimen finally confirmed it to be a KCOT. The clinical, radiological and histological features of this tumour along with its surgical management have been discussed. PMID:23429028

  3. Keratocystic odontogenic tumour (KCOT) misdiagnosed as a dentigerous cyst.

    PubMed

    Chaudhary, Seema; Sinha, Ashish; Barua, Pranamee; Mallikarjuna, Rachappa

    2013-01-01

    Keratocystic odontogenic tumours are known for their peculiar behaviour, varied origin, debated development, unique tendency to recur and disputed treatment modalities. Thus, it has been the subject of much research over the last 40 years. It was formerly known as odontogenic keratocyst (OKC). OKC received its new title as keratocystic odontogenic tumour (KCOT) by the WHO (2005) in order to suggest its aggressive and recurrent nature. KCOT is a benign intraosseous neoplasm of the jaw. Involvement of the maxillary sinus is an unusual presentation. We present the case of an 11-year-old child with extensive KCOT and an impacted canine in the right maxillary sinus. The cyst was initially misdiagnosed to be a dentigerous cyst based on the clinical and radiographic features though a differential diagnosis of KCOT and adenomatoid odontogenic tumour was made. The histological examination of the specimen finally confirmed it to be a KCOT. The clinical, radiological and histological features of this tumour along with its surgical management have been discussed. PMID:23429028

  4. Trends in Squamous Cell Carcinoma of the Vulva: The Influence of Vulvar Intraepithelial Neoplasia

    Microsoft Academic Search

    R. W Jones; Judith Baranyai; S Stables

    1997-01-01

    Objective: To determine trends in the clinicopathology of vulvar squamous cell carcinoma over the past 2 decades, with particular reference to the possible effects of the increasing incidence of vulvar intraepithelial neoplasia (VIN) during this time.Methods: Two cohorts of 56 and 57 women with squamous cell carcinoma of the vulva and separated by at least 2 decades were reviewed retrospectively.

  5. let-60, a Gene That Specifies Cell Fates during C. elegans Vulva1 Induction, Encodes a MS Protein

    Microsoft Academic Search

    Min Han; Paul W. Sternberg

    Summary Genetic analysis previously suggested that the 181-60 gene controls the switch between vulva1 and hypoder- mal cell fates during C. elegans vulva1 induction. We have cloned the let-60 gene, and shown that it en- codes a gene product ldentlcal in 84% of its first 164 amino acids to ras gene products from other ver- tebrate and invertebrate species. This

  6. Smoking, Obesity, and Survival in Squamous Cell Carcinoma of the Vulva

    Microsoft Academic Search

    Carolyn V. Kirschner; Edgardo L. Yordan; Koen De Geest; George D. Wilbanks

    1995-01-01

    One hundred thirty-six patients with invasive squamous cell carcinoma of the vulva were studied retrospectively to determine prognostic factors for survival. In the regression analysis, three variables were statistically significantly related to survival: smoking history, tumor size, and node status. Smokers had a 6.3 times greater risk of death than nonsmokers, node positivity imparted an 8.3 times greater risk than

  7. Primary breast carcinoma of the vulva: case report and review of literature.

    PubMed

    Piura, B; Gemer, O; Rabinovich, A; Yanai-Inbar, I

    2002-01-01

    The occurrence of ectopic breast tissue within the vulva is uncommon and the development of breast carcinoma within vulvar ectopic breast tissue is very rare. To date, only 12 cases of primary vulvar breast carcinoma have previously been reported in the English literature. This paper presents the 13th reported case of primary breast carcinoma of the vulva. The patient presented with a vulvar ulcerated lump and the diagnosis was based on a morphologic pattern consistent with breast carcinoma and the presence of estrogen and progesterone receptors. Primary surgery consisted of radical vulvectomy and bilateral groin dissection. The groin lymph nodes were involved bilaterally. Adjuvant therapy consisted of systemic chemotherapy (4 cycles of adriamycin and cyclophosphamide followed by 4 cycles of paclitaxel) and pelvic radiotherapy. Oral tamoxifen 20 mg/day was started for the next five years. It is concluded that the management of primary breast carcinoma of the vulva should be modeled after that for primary carcinoma of the orthotopic breast with primary surgery followed by systemic chemotherapy and pelvic radiotherapy. Chemotherapy should be similar to that employed for breast carcinoma. Tamoxifen should be prescribed for patients whose tumors contain estrogen receptors. PMID:11876386

  8. Unusual benign polypoid and papular neoplasms and tumor-like lesions of the vulva.

    PubMed

    AbdullGaffar, Badr; Keloth, Tasnim R; Raman, Lakshmiah G; Mahmood, Suaad; Almulla, Amal; AlMarzouqi, Mamoun; Al-Hasani, Salam

    2014-04-01

    We aimed to investigate the prevalence and spectrum of unusual benign neoplasms and tumor-like lesions presenting as vulvar polyps and papules, to study their clinical, pathologic, hormonal, and developmental features and whether they have important associations with other pathologic lesions or clinical diseases. We conducted a retrospective review study of 115 vulvar specimens over 7 years. Common lesions, for example, fibroepithelial polyps, skin tags, papillomas, abscesses, viral warts and common cysts, were excluded. We found 21 cases (18%) with uncommon benign vulvar lesions. They included 7 epithelial cysts, 3 vascular lesions, 3 glandular neoplasms, 3 endometrioses, 1 caruncle, 1 pilonidal sinus, 1 prolapsed urethra, 1 seborrheic keratosis, and 1 granular cell tumor. The age range was between 1 and 64 years with a mean age of 33 years. Most (86%) were 2.5 cm or less. Many were asymptomatic incidental pathologic findings that can be missed clinically. Nine cases have important clinical associations or coexisting incidental pathologic lesions. Some lesions demonstrated hormone receptors. Some were clinically confused with fibroepithelial polyps, abscesses, warts, melanocytic lesions, and tumors. In conclusion, although the vulva is a small compartment, its developmental and histologic complexity can result in a variety of unusual and rare benign polypoid and papular lesions, some unique to the vulva, which might present diagnostic challenges to the clinicians and pathologists. In addition, many bear controversy regarding their histogenesis and origin of development in the vulva. PMID:24342664

  9. Malignant peripheral nerve sheath tumor of the vulva, an unusual differential diagnosis for vulvar mass

    PubMed Central

    Özdal, Bülent; Öz, Murat; Korkmaz, Elmas; Atao?lu, Ömür; Güngör, Tayfun; Meydanli, Mehmet Mutlu

    2014-01-01

    INTRODUCTION Malignant peripheral nerve sheath tumors (MPNSTs) are rare, up to one half of the MPNSTs occur in patients with neurofibromatosis type-1 (NF-1), while the rest are sporadic. Here, we present a 52-year-old woman with MPNST of the vulva without NF-1. We will discuss basics of the disease, treatment options and follow-up strategies. PRESENTATION OF CASE 52-year-old female admitted to our hospital with complaint of abnormal uterine bleeding and rapidly growing vulvar mass. Excisional biopsy of the mass showed MPNST of the vulva. Afterwards, the patient underwent radical vulvectomy with inguinofemoral lymph node dissection. Short after the surgery, multiple lung metastasis were shown and responded to chemotherapy, but rapid local recurrence occurred short after the completion of the chemotherapy. DISCUSSION The primary treatment option in MPNSTs is surgical excision with or without adjuvant therapy. There is not enough data about the role of systemic chemotherapy in the management of MPNSTs and it still remains controversial. CONCLUSION In general, radiation therapy has not been demonstrated to improve overall survival. Complete surgical resection of the primary tumor is the mainstay of the treatment. PMID:25290384

  10. Caroli's disease misdiagnosed as intraductal papillary neoplasm of the bile duct

    PubMed Central

    Gu, Dae Hoe; Park, Min Seon; Jung, Chang Ho; Yoo, Yang Jae; Cho, Jae Young; Lee, Yun Ho; Yim, Hyung Joon; Um, Soon Ho; Ryu, Ho Sang

    2015-01-01

    Caroli's disease is a rare autosomal-recessive disorder caused by malformation of the ductal plate during embryonic development. Although it is present at birth, Caroli's disease is typically not diagnosed until between the second and fourth decades of life, as it was in the present patient. Here we report a rare case of Caroli's disease limited to one liver segment, which was initially misdiagnosed as an intraductal papillary neoplasm of the bile duct. The asymptomatic patient was treated with liver segmentectomy.

  11. Misdiagnosed or Incidentally Detected Hepatocellular Carcinoma in Explanted Livers: Lessons Learned.

    PubMed

    Abdelfattah, Mohamed Rabei; Abaalkhail, Faisal; Al-Manea, Hadeel

    2015-01-01

    BACKGROUND Misdiagnosed or incidentally detected hepatocellular carcinoma (HCC) in liver explant is an undesirable surprise that might pose a medical challenge in the post-transplant setting. MATERIAL AND METHODS From May 2001 to the end of December 2013, 463 and 137 liver transplants for adult and pediatric patients, respectively, were performed at our center. Ten cases were found to have misdiagnosed or incidental malignant lesions on pathological examination of the explant. RESULTS We considered 105 patients for LT because of presence of HCC; 102 patients were accurately diagnosed by pretransplant imaging and the other 3 patients were misdiagnosed as HCC and then found to have mixed HCC-cholangiocarcinoma (CC) (2.9% misdiagnosis rate). Seven more patients were found to have i-HCC in explanted livers. Therefore, 109 patients were transplanted for presence of HCC (6.5% of them diagnosed incidentally). The overall rate of incidental HCC (i-HCC) among all liver explants was 1.2%. In the adult group no subjects had HCC recurrence, while only 1 subject had HCC recurrence in the pediatric group. All mixed HCC-CC lesions were found in adult patients. Two patients died from recurrence of cholangiocarcinoma after liver transplant. The other patient is still surviving with no recurrence at 13-month follow-up. CONCLUSIONS Misdiagnosed or incidental malignancy is a rare but reported finding following liver transplantation. Their preoperative suspicion is quite challenging. A thorough explant pathology study is needed to diagnose this condition. It is evident that the outcome of this undesirable finding was judged mainly by tumor biology. PMID:26124187

  12. Keratotic horn on left fifth fingertip: congenital ectopic nail misdiagnosed as a common wart.

    PubMed

    Bilenchi, Roberta; Poggiali, Sara; De Paola, Mariele; Batsikosta, Natasha; Fimiani, Michele

    2013-01-01

    The term "ectopic nail" refers to nail tissue found in a location other than in the normal nail bed. Here we report a 9-year-old girl with an asymptomatic keratotic "horn" on the tip of her left fifth finger. Present since the age of 1?month, it was misdiagnosed as a common wart and treated using liquid nitrogen cryotherapy without benefit. PMID:22277059

  13. Light- and electron-microscopic findings in lichen sclerosus of the vulva during etretinate treatment.

    PubMed

    Romppanen, U; Rantala, I; Lauslahti, K; Reunala, T

    1987-01-01

    Fifteen women with lichen sclerosus (LS) of the vulva were treated for 3 months with 0.6 mg/kg of etretinate. The clinical response was good in 11/15 of the patients and, in agreement with this, light microscopy showed decreasing atrophy and hyperkeratosis together with subsiding inflammatory changes. However, orcein staining demonstrated that even after etretinate treatment, elastic fibers were still absent in the upper dermis with only few fibers being detectable in some specimens. Conventional electron microscopy and immunoelectron microscopy were used to examine these changes more in detail. Antiserum to the microfibrillar part of the elastic fibers confirmed that only remnants of microfibrillar coat persisted in the upper dermis and that deeper in the dermis, elastic fibers were porous and fragmented. These findings demonstrate that despite the normalization of clinical and certain histological parameters during etretinate treatment, the initial elastic fiber damage persists both at the light- and electronmicroscopic levels. PMID:3609415

  14. Smoking, obesity, and survival in squamous cell carcinoma of the vulva.

    PubMed

    Kirschner, C V; Yordan, E L; De Geest, K; Wilbanks, G D

    1995-01-01

    One hundred thirty-six patients with invasive squamous cell carcinoma of the vulva were studied retrospectively to determine prognostic factors for survival. In the regression analysis, three variables were statistically significantly related to survival: smoking history, tumor size, and node status. Smokers had a 6.3 times greater risk than nonsmokers, node positivity imparted an 8.3 times greater risk than node negativity, and for each 1-cm increase in the size of the tumor, the risk of death increased by 46%. A relative decrease in survival in smokers was observed, despite a younger age and fewer positive nodes at diagnosis compared to nonsmokers. Increased surveillance in these patients may be warranted. PMID:7821852

  15. Neoadjuvant chemoradiotherapy followed by surgery in locally advanced squamous cell carcinoma of the vulva

    PubMed Central

    GAUDINEAU, A.; WEITBRUCH, D.; QUETIN, P.; HEYMANN, S.; PETIT, T.; VOLKMAR, P.; BODIN, F.; VELTEN, M.; RODIER, J.F.

    2012-01-01

    Alternative therapies have been sought to alleviate mutilation and morbidity associated with surgery for vulvar neoplasms. Our prime objective was to assess tumor absence in pathological vulvar and nodal specimens following neoadjuvant chemoradiotherapy in locally advanced vulvar neoplasms. Data were retrospectively collected from January 2001 to May 2009 from 22 patients treated with neoadjuvant therapy for locally advanced squamous cell carcinoma of the vulva. Neoadjuvant treatment consisted of inguino-pelvic radiotherapy (50 Gy) in association with chemotherapy when possible. Surgery occurred at intervals of between 5 to 8 weeks. The median age of patients at diagnosis was 74.1 years. All patients were primarily treated with radiotherapy and 15 received a concomitant chemotherapy. Additionally, all patients underwent radical vulvectomy and bilateral inguino-femoral lymphadenectomy. Tumor absence in the vulvar and nodal pathological specimens was achieved for 6 (27%) patients, while absence in the vulvar pathological specimens was only achieved for 10 (45.4%) patients. Postoperative follow-up revealed breakdown of groin wounds, vulvar wounds and chronic lymphedema in 3 (14.3%), 7 (31.8%) and 14 cases (63.6%), respectively. Within a median follow-up time of 2.3 years [interquartile range (IQR), 0.6–4.6], 12 (54.6%) patients experienced complete remission and 6 cases succumbed to metastatic evolution within a median of 2.2 years (IQR, 0.6–4.6), with 1 case also experiencing perineal recurrence. Median survival time, estimated using the Kaplan-Meier method, was 5.1 years (IQR, 1.0–6.8). We suggest that neoadjuvant chemoradiotherapy may represent a reliable and promising strategy in locally advanced squamous cell carcinoma of the vulva. PMID:23205089

  16. Successful Treatment of Congenital Lymphangioma Circumscriptum of the Vulva with CO2 and Long-Pulsed Nd:YAG Lasers

    PubMed Central

    Sasaki, Ryosuke; Negishi, Kei; Akita, Hirotaka; Suzuki, Kayoko; Matsunaga, Kayoko

    2014-01-01

    A 16-year-old girl presented with a 9-year history of vesicles on the vulva. She had initially taken a wait-and-see approach, but required treatment because of bleeding. Histological examination of a biopsied vesicle revealed dilated lymph channels in the upper dermis, suggesting lymphangioma circumscriptum (LC). The challenge for this pathology has been to find a conservative treatment with low morbidity and better results than those reported for surgical excision, which has been the mainstay of therapy. In this case, LC of the vulva was successfully treated using a 10,600-nm CO2 laser and long-pulsed Nd:YAG laser. Use of the 10,600-nm CO2 laser and long-pulsed Nd:YAG laser appeared effective for treating LC. PMID:24575003

  17. Lichen sclerosus: a potpourri of misdiagnosed cases based on atypical clinical presentations

    PubMed Central

    Ventolini, Gary; Patel, Ravi; Vasquez, Robert

    2015-01-01

    Objective Lichen sclerosus (LS) is a chronic progressive inflammatory autoimmune-induced disease that primarily affects the epidermis and dermis of the external genital-anal region. Intense and recalcitrant pruritus is the hallmark of LS. Physical exam reveals thinning, hyperkeratosis, and parchment-like appearance. However, the classic symptom and signs of LS may not always be present and patients may be asymptomatic for pruritus. Hence, we describe 15 misdiagnosed cases with atypical clinical presentations. We believe that the absence of pruritus contributed to their initial misdiagnosis. The purpose of this paper is to increase awareness of atypical presentations of LS. Methods Data base review of de-identified clinical case pictures was performed. All patients had histopathology-confirmed diagnoses of LS. The data base file contains 800 cases of vulvovaginal disorders. The Institutional Review Board (IRB) considered that searching a de-identified data base of pictures did not require IRB approval. Results We identified 15 different atypical clinical cases. Patient ages were 18–75 years old. These patients were asymptomatic for pruritus and were misdiagnosed before they presented to the vulvovaginal specialized clinic. Conclusion Fifteen patients asymptomatic for pruritus with histopathology-confirmed diagnosis of LS were identified. They illustrate atypical clinical presentations that LS may have. PMID:26056492

  18. Serum levels of vitamin A, E, and selenium in women with lichen sclerosus of the vulva treated with etretinate.

    PubMed

    Romppanen, U; Tuimala, R; Ellmén, J; Koskinen, T; Pyykkö, K

    1988-01-01

    Forty-six patients with Lichen sclerosus (Ls) of the vulva were treated with peroral etretinate for 3 months. The pretreatment serum levels of vitamins A and E, and selenium were measured. Etretinate therapy proved to be effective in the treatment of Ls; however, it did not affect the vitamin A status of the Ls patients. Vitamin E and selenium levels did not differ from the control values, nor did they have any prognostic value. PMID:3343023

  19. Preoperative chemo-radiation for carcinoma of the vulva with N2\\/N3 nodes: a gynecologic oncology group study

    Microsoft Academic Search

    Gustavo S Montana; Gillian M Thomas; David H Moore; Angelika Saxer; Charles E Mangan; Samuel S Lentz; Hervy E Averette

    2000-01-01

    Purpose: To determine if patients with carcinoma of the vulva, with N2\\/N3 lymph nodes, could undergo resection of the lymph nodes and primary tumor following preoperative chemo-radiation.Methods and Materials: Fifty-two patients were entered in the study, but six patients did not meet the criteria of the protocol and were excluded. The remaining 46 patients are the subject of this report.

  20. Malignant Rhabdoid Tumor of the Vulva: Case Report and Review of the Literature with Emphasis on Clinical Management and Outcome

    Microsoft Academic Search

    A. Brand; A. Covert

    2001-01-01

    Background. Malignant extrarenal rhabdoid tumors (ERTs) of the vulva are rare but aggressive neoplasms. We describe the eighth reported case and the first to have long-term survival despite initial rapid recurrence.Case. A 40-year-old woman presented with a painless lump on the mons pubis. It was excised and revealed an ERT. One month later, the tumor had regrown. A wide local

  1. Dermatofibrosarcoma protuberans of the vulva: a mesenchymal tumour with a broad differential diagnosis and review of literature.

    PubMed

    Gilani, S; Al-Khafaji, B

    2014-12-01

    Dermatofibrosarcoma protuberans (DFSP) is a malignant cutaneous soft tissue tumour, which rarely presents in the vulva. We report an unusual case of this tumour involving the vulva. A 61-year-old female presented with a mass in the left mons pubis. Subsequent excisional biopsy of the mass was performed. Histologic evaluation of the specimen showed a spindle cell lesion consisting of fibroblast-like cells arranged in a storiform pattern. On average, there were 2 to 3 mitotic figures per 10 high power field (hpf). The neoplastic cells showed extension into the surrounding fibroadipose tissue. A panel of immunohistochemical stains including CD34, S-100, melan-A, HMB-45, vimentin and smooth muscle actin (SMA) were tested. The neoplastic cells showed diffuse staining with CD34 and vimentin, while the rest were negative. Based on the morphologic and immunohistochemical staining pattern, a diagnosis of DFSP was rendered. The patient underwent two subsequent resections before she had clear resection margins. The postoperative course was unremarkable. The patient is disease free without recurrence after a follow-up of 12 months. DFSP infrequently involves the vulva and should be considered in the differential diagnosis of other spindle cell lesions presenting in this unusual site. The role of immunohistochemical staining with CD34 is imperative in establishing the diagnosis. The rate of local reoccurrence is high, but it rarely shows metastasis. Treatment of choice is wide local surgical excision with close follow-up to detect reoccur- rence. PMID:25845051

  2. Could cryosurgery be an alternative treatment for basal cell carcinoma of the vulva?

    PubMed

    Rodríguez, Verónica Garza; De la Fuente García, Alberto; Torres, Myrna Alejandra Cardoza; Flores, Minerva Gómez; Moreno, Gildardo Jaramillo; Candiani, Jorge Ocampo

    2014-04-01

    Basal cell carcinomas (BCC) on the genital area account for less than 1% of all BCCs. Surgical management is indicated. Recurrence rate of vulvar BCC has been reported to be 10-20%. Mohs micrographic surgery (MMS) is a superior surgical option. Other treatments include radiation and topical immuntherapy. Cryosurgery for vulvar BCC has not been reported. We present the case of a 88-year-old Hispanic woman with a vulvar ulcer that was confirmed as BCC by histopathology and treated with liquid nitrogen cryosurgery. Control biopsy was performed on day 90 was negative for BCC. No clinical evidence of recurrence was detected after one year. Although, the vulva is considered to be a high-risk site with respect to BCC and MMS is the gold standard for treatment, the delicate nature of the area may preclude complete removal by a surgical technique without compromising vital anatomical function. Liquid nitrogen cryosurgery uses the effects of extreme cold to effect deep destruction of the tumor and surrounding tissues. This is the first report of a vulvar BCC successfully treated with liquid nitrogen cryosurgery. We suggest this technique could be of benefit as an alternative treatment in cases where excisional procedures cannot be performed. PMID:24860751

  3. Could cryosurgery be an alternative treatment for basal cell carcinoma of the vulva?

    PubMed Central

    Rodríguez, Verónica Garza; De la Fuente García, Alberto; Torres, Myrna Alejandra Cardoza; Flores, Minerva Gómez; Moreno, Gildardo Jaramillo; Candiani, Jorge Ocampo

    2014-01-01

    Basal cell carcinomas (BCC) on the genital area account for less than 1% of all BCCs. Surgical management is indicated. Recurrence rate of vulvar BCC has been reported to be 10-20%. Mohs micrographic surgery (MMS) is a superior surgical option. Other treatments include radiation and topical immuntherapy. Cryosurgery for vulvar BCC has not been reported. We present the case of a 88-year-old Hispanic woman with a vulvar ulcer that was confirmed as BCC by histopathology and treated with liquid nitrogen cryosurgery. Control biopsy was performed on day 90 was negative for BCC. No clinical evidence of recurrence was detected after one year. Although, the vulva is considered to be a high-risk site with respect to BCC and MMS is the gold standard for treatment, the delicate nature of the area may preclude complete removal by a surgical technique without compromising vital anatomical function. Liquid nitrogen cryosurgery uses the effects of extreme cold to effect deep destruction of the tumor and surrounding tissues. This is the first report of a vulvar BCC successfully treated with liquid nitrogen cryosurgery. We suggest this technique could be of benefit as an alternative treatment in cases where excisional procedures cannot be performed. PMID:24860751

  4. A persistently recurring peri-urethral soft tissue lesion of the vulva.

    PubMed

    Leunen, M; Goossens, A; Bourgain, C; De Sutter, P; Michielsen, D; Amy, J J

    2005-01-01

    Various mesenchymal lesions, some of which have only recently been characterized, may affect the vulva. Because of their apparently shared origin from vulvovaginal mesenchyme, these lesions can resemble one another superficially and can be challenging diagnostically. Clinically, benign lesions and tumor-like conditions may mimic a malignant process because of hypercellularity, mitotic activity, and rapid growth. We report on a 84-year-old diabetic and hypertensive woman who had previously undergone skinning vulvectomy for lichen planus and an embolectomy of the left femoral artery. The patient presented with a rapidly growing vulvar mass. The biopsy showed spindle cell proliferation in a loose myxoid stroma with granulation tissue and a mixed inflammatory infiltrate. Based on histology and immunohistochemistry, the initial diagnosis was that of a benign lesion. In view of the persistent recurrence of the lesion and the absence of metastatic spread, we conclude that the lesion has a low-grade malignant potential and suggest the diagnosis of florid cellular reactive pseudosarcomatous myofibroblastic proliferation. PMID:15807313

  5. Spinal Textiloma (Gossypiboma): A Report of Three Cases Misdiagnosed as Tumour

    PubMed Central

    ?ahin, Soner; Atabey, Cem; ?im?ek, Mehmet; Naderi, Sait

    2013-01-01

    Background: Textile products commonly used in surgery (e.g., sponges or gauze) have been known to cause complications after spinal surgery. Associated complications usually arise months or even years after the primary surgery. In case of spine surgery, these bodies are often detected during neuroradiological evaluations to investigate reported back pain; however, this complication often remains asymptomatic. Aims: The research is intended to increase awareness among both spinal surgeons and neuroradiologists of this potential complication. Study Design: Retrospective study. Methods: This study is a retrospective case series of three patients with retained surgical textile products who had been misdiagnosed with spinal tumour. The medical records of the patients were reviewed and demographic data, clinical aspects, initial diagnosis, surgical procedures, time interval between previous operation and onset of symptoms, laboratory findings, radiological findings, treatment, and outcome were analysed. Results: The three patients included two women and one man aged between 64 and 67 years. All patients had a previous surgery for lumbar disc herniation. The time from the previous surgical procedures to presentation ranged from 3 to 17 years. All patients presented with non-specific lower back pain and/or radiculopathy without clinical findings of infection. Laboratory parameters were otherwise normal. All three cases had been misdiagnosed as a spinal tumor based on magnetic resonance imaging findings. During new surgical procedures, gauze bandages, i.e., surgical textiles left during a previous operation, were found. Conclusion: Textiloma is an important and rarely mentioned potential neurosurgical complication that may remain asymptomatic for years. They are more common in obese patients, after emergency surgery, and with unplanned changes in surgical procedure such as bleeding and unintended neurosurgical complications. Neuroradiological findings are variable and non-specific; thus, patients could be misdiagnosed with a spinal tumor or abscess. Likewise, in patients with a history of spinal surgery, spinal abscesses, haematomas, hypertrophic scars, fibrosarcomas, rhabdomyosarcomas, and schwannomas should definitely be considered in the differential diagnosis and considered when planning diagnostic procedures. Appropriate antibiotic therapy is recommended when a suppurative complication is present or suspected. Textiloma is a medico-legal complication that can be prevented by the education of surgical staff, the counting method (preoperatively, at closure, and at the end), and use of products with radiopaque barcodes. PMID:25207152

  6. Torsade de pointes in a patient with complete atrioventricular block and pacemaker failure, misdiagnosed with epilepsy.

    PubMed

    Cai, Si-Yu; Ye, Shen-Feng; Wu, Xiang; Xiang, Mei-Xiang; Wang, Jian-An

    2015-01-01

    A case of torsade de pointes (TdP) with complete atrioventricular block and pacemaker failure that was misdiagnosed as epilepsy is presented herein. An 82-year-old female with recurrent seizure-like attacks showed epileptiform discharge during an electroencephalogram recording. A long QT interval and severe hypokalemia induced runs of TdP, which was related to pacemaker lead fracture, was detected during Holter recording and accompanied with episodes of seizures. After a DDD pacemaker with a new ventricular lead was replaced, there was no recurrence of any seizure-like attacks. Bradycardia-mediated TdP associated with complete atrioventricular block should not be missed in patients with recurrent seizure-like attacks even after pacemaker implantation. PMID:25771702

  7. Complicated benign cystic mesothelioma of mesoappendix misdiagnosed as an appendiceal abscess in a postpartum period woman.

    PubMed

    Yeom, Sunchul; Son, Taeil; Hong, Young Ok

    2015-03-01

    Benign cystic mesothelioma is an uncommon tumor arising from the peritoneal mesothelium. It is characterized by multilocular grapelike, thin-, and translucent-walled cysts, or a unilocular cyst lined by benign mesothelial cells. It occurs predominantly in women of reproductive age, and shows a predilection for the surface of the pelvic peritoneum or visceral peritoneum. Patients usually present abdominal pain and palpable mass, but many cases have been found incidentally during laparotomy. Definite preoperative diagnosis is known to be difficult. Benign cystic mesothelioma has a tendency towards local recurrence, although the gross microscopic features are benign. Moreover, there is controversy over whether this disease is neoplastic or reactive. Initial complete surgical resection and cytoreductive surgery for recurred cases are standard treatments. In the following report, we describe a case of complicated benign cystic mesothelioma in a postpartum woman, involving the pelvic peritoneum and mesoappendix, which was initially misdiagnosed as a periappendiceal abscess. PMID:25741498

  8. Phthiriasis palpebrarum misdiagnosed as allergic blepharoconjunctivitis in a 6-year-old girl.

    PubMed

    Yi, Jun Wen; Li, Li; Luo, Da Wei

    2014-01-01

    Phthiriasis palpebrarum is an infestation of the eyelashes caused by the louse Pthirus pubis (Linnaeus, 1758). We report a case of phthiriasis palpebrarum in a 6-year-old girl, which was initially misdiagnosed as allergic blepharoconjunctivitis. Parasites and their nits were found adhering to the eyelashes and eyelids of her right eye as well as scalp hairs. No abnormality was found in the left eye. The histopathology exam revealed the presence of adults and eggs of Pthirus pubis. We mechanically removed all the eyelashes of the right eye at their base, with lice and nits. The scalp was shaved and washed with phenothrin shampoo. No recurrence was found during 3 months of follow-up. Removal of the eyelashes, cutting of scalp hairs, and phenothrin shampoo may be effective in treating phthiriasis palpebrarum. In cases of blepharoconjunctivitis, eyelids and eyelashes should be carefully examined by slit lamp to avoid misdiagnosis. PMID:24909484

  9. Myoclonic status misdiagnosed as movement disorders in Rett syndrome: a video-polygraphic study.

    PubMed

    d'Orsi, Giuseppe; Demaio, Vincenzo; Minervini, Mauro G

    2009-06-01

    Myoclonic jerks and myoclonic status (MS) are sometimes difficult to distinguish clinically from movement disorders such as hand stereotypies, tremor, and dystonia in Rett syndrome. We describe a rare and complete video-polygraphic study of a girl with Rett syndrome (MECP2 mutation) and MS misdiagnosed as movement disorders and disclosed after video-polygraphic recordings. Corresponding to closely recurring activity of diffuse spike and polyspikes-wave-type paroxysms, rhythmic and, especially, arrhythmic myoclonias, usually asymmetrical and asynchronous, involving mainly right muscle deltoid and rarely followed by an inhibitory phenomenon, appeared. The MS improved and, most importantly, disappeared after the use of levetiracetam, with an evident antimyoclonic efficacy and a marked improvement of daily life for the patient and her caregivers. The difficulty in differentiating some typical nonepileptic behavioral features and movement disorders of patients with Rett syndrome from seizures was overcome using prolonged video-polygraphic recordings in our case. PMID:19336260

  10. Cherubism misdiagnosed as giant cell tumor: a case report and review of literature

    PubMed Central

    Jiao, Yang; Zhou, Mi; Yang, Yaowu; Zhou, Jun; Duan, Xiaohong

    2015-01-01

    Cherubism is characterized by progressive, painless, bilateral enlargement of the mandible and/or maxilla resulting from the replacement of bone with multilocular cysts composed of fibrotic stromal cells and osteoclast-like cells. Here we report one Chinese cherubism case that has been misdiagnosed for more than forty years. The patient displayed no typical clinical or radiographical signs of cherubism due to multi-surgical treatments. Her histopathologic examination revealed the proliferating fibrous connective tissue with few multinucleated giant cells. The family history suggested us to perform sequence analysis of the SH3BP2 gene, a candidate marker for cherubism, in the family, and it was found that both the proband and the son had a missense mutation in SH3BP2 in exon 9 (p. Arg415Gln). Here we emphasize the importance of gene testing in the diagnosis of suspected cherubism, especially for those cases with non-typical clinical, radiographic and histological presentations.

  11. Gastric Schwannoma mimicking malignant gastrointestinal stromal tumor and misdiagnosed by (18)F-FDG PET/CT.

    PubMed

    Zhang, Yiqiu; Li, Beilei; Cai, Liang; Hou, Xiaoguang; Shi, Hongcheng; Hou, Jun

    2015-01-01

    Gastric Schwannoma is a rare benign mesenchymal tumor that accounts for only 0.2% of all gastric tumors. The current study presents a case of gastric Schwannoma misdiagnosed as malignant gastrointestinal stromal tumor (GIST) by esophagogastroduodenoscopy, endoscopic ultrasonography, and contrast-enhanced or not enhanced and (18)F-FDG PET/CT imaging. PMID:25840576

  12. Misdiagnosed amoebic colitis leading to severe dysentery and necrotizing colitis--report of a case and review of the literature.

    PubMed

    Mogensen, Trine H; Christiansen, Jens J; Eivindson, Martin V; Larsen, Carsten S; Tøttrup, Anders

    2014-03-01

    We present a case of amoebic colitis, misdiagnosed as inflammatory bowel disease and treated with corticosteroids, leading to severe necrotizing enterocolitis. We review the literature on the epidemiology, pathogenesis, diagnosis, and treatment of amoebic dysentery, with special emphasis on the association between immunosuppressive treatment and the development of severe invasive amoebiasis. PMID:24450838

  13. Staphylococcus pseudintermedius can be misdiagnosed as Staphylococcus aureus in humans with dog bite wounds.

    PubMed

    Börjesson, S; Gómez-Sanz, E; Ekström, K; Torres, C; Grönlund, U

    2015-04-01

    The purpose of this study was to investigate whether S. pseudintermedius is misdiagnosed as S. aureus by clinical laboratories when isolated from humans with dog bite wounds. In addition, we attempted to determine whether S. pseudintermedius isolates related to dog bite wounds share phenotypic and genotypic traits. S. pseudintermedius was identified by PCR targeting the nuc gene. Isolates were tested for antibiotic susceptibility using VetMIC GP-mo microdilution panels. The occurrence of genes encoding leukocidins, exfoliatins, pyrogenic toxin superantigens and enterotoxins was determined by PCR. The relatedness of S. pseudintermedius isolates was investigated using Multi Locus Sequence Typing (MLST). Out of 101 isolates defined as S. aureus by human clinical microbiology laboratories, 13 isolates were re-identified as S. pseudintermedius and one isolate was confirmed to carry the mecA gene, i.e. methicillin-resistant (MRSP). The MRSP isolate was also defined as multi-resistant. Two methicillin-susceptible S. pseudintermedius isolates were also multi-resistant and five were susceptible to all antibiotics tested. With the exception of three S. pseudintermedius isolates belonging to multi locus sequence type (MLST) 158, all the isolates belonged to unique STs. All isolates contained lukS/F-I, siet and se-int, and expA were identified in two isolates and expB and sec canine-sel in one isolate respectively. S. pseudintermedius is frequently misdiagnosed as S. aureus from humans with dog bite wounds showing that it can act as an opportunistic pathogen in humans. No common phenotypic and genotypic traits shared by the S. pseudintermedius isolates could be identified. PMID:25532507

  14. [A case of sellar germinoma which was misdiagnosed as pituitary adenoma].

    PubMed

    Arita, K; Uozumi, T; Kuwabara, S; Mukada, K; Sumida, M; Sugiyama, K; Watanabe, K; Saito, Y

    1991-11-01

    The authors reported a rare case of sellar germinoma which was misdiagnosed as nonfunctioning pituitary adenoma. A 32-year-old woman was admitted to our hospital because of amenorrhea and disturbance of left visual acuity. She had become amenorrhagic after her second delivery two years before. Neurological examination revealed she was normal except for diminished left visual acuity (Rt. = 1.2, Lt. = 0.5). The general condition was good. Urine volume and its specific gravity were within normal range. Endocrinological examination showed hyperprolactinemia (PRL 72 ng/ml) accompanied with impairment of GH, TSH, LH and FSH's reserve. Basal levels and reserve of the blood cortisol were normal. AFP and hCG were within normal range. CT scan revealed a homogenously enhanced intrasellar tumor which had a suprasellar portion (vertical length: 15 mm). T1 weighted MRI revealed low intensity tumor, and T2 weighted image revealed high intensity tumor. Sagittal MR image with gadolinium enhancement showed the pituitary gland anterior to the tumor. Transsphenoidal removal was performed. The histological diagnosis was pure germinoma. After the operation, the intracranial and spinal disseminations were disclosed. Complete neuraxis irradiation resulted in the complete remission of the tumor. Sellar germinoma without diabetes insipidus is considered to be very difficult to diagnose preoperatively. However, the authors proposed that anterior shift of the pituitary gland in sagittal MR image may be a clue to the diagnosis of sellar germinoma. PMID:1762658

  15. Metastatic uterine leiomyosarcoma in the upper buccal gingiva misdiagnosed as an epulis.

    PubMed

    Cassoni, Andrea; Terenzi, Valentina; Bartoli, Davina; Zadeh, Oriana Rajabtork; Battisti, Andrea; Pagnoni, Mario; Conte, Davide; Lembo, Alessandro; Bosco, Sandro; Alesini, Francesco; Valentini, Valentino

    2014-01-01

    Uterine leiomyosarcoma (LMS) is a rare tumor constituting 1% of all uterine malignancies. This sarcoma demonstrates an aggressive growth pattern with an high rate of recurrence with hematologic dissemination; the most common sites are lung, liver, and peritoneal cavity, head and neck district being rarely interested. Only other four cases of metastasis in the oral cavity have been previously described. The treatment of choice is surgery and the use of adjuvant chemotherapy and radiation has limited impact on clinical outcome. In case of metastases, surgical excision can be performed considering extent of disease, number and type of distant lesions, disease free interval from the initial diagnosis to the time of metastases, and expected life span. We illustrate a case of uterine LMS metastasis in the upper buccal gingiva that occurred during chemotherapy in a 63-year-old woman that underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy for a diagnosis of LMS staged as pT2bN0 and that developed lung metastases eight months after primary treatment. Surgical excision of the oral mass (previously misdiagnosed as epulis at a dental center) and contemporary reconstruction with pedicled temporalis muscle flap was performed in order to improve quality of life. Even if resection was achieved in free margins, "local" relapse was observed 5 months after surgery. PMID:25386373

  16. Metastatic Uterine Leiomyosarcoma in the Upper Buccal Gingiva Misdiagnosed as an Epulis

    PubMed Central

    Cassoni, Andrea; Terenzi, Valentina; Bartoli, Davina; Zadeh, Oriana Rajabtork; Battisti, Andrea; Pagnoni, Mario; Conte, Davide; Lembo, Alessandro; Bosco, Sandro; Alesini, Francesco; Valentini, Valentino

    2014-01-01

    Uterine leiomyosarcoma (LMS) is a rare tumor constituting 1% of all uterine malignancies. This sarcoma demonstrates an aggressive growth pattern with an high rate of recurrence with hematologic dissemination; the most common sites are lung, liver, and peritoneal cavity, head and neck district being rarely interested. Only other four cases of metastasis in the oral cavity have been previously described. The treatment of choice is surgery and the use of adjuvant chemotherapy and radiation has limited impact on clinical outcome. In case of metastases, surgical excision can be performed considering extent of disease, number and type of distant lesions, disease free interval from the initial diagnosis to the time of metastases, and expected life span. We illustrate a case of uterine LMS metastasis in the upper buccal gingiva that occurred during chemotherapy in a 63-year-old woman that underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy for a diagnosis of LMS staged as pT2bN0 and that developed lung metastases eight months after primary treatment. Surgical excision of the oral mass (previously misdiagnosed as epulis at a dental center) and contemporary reconstruction with pedicled temporalis muscle flap was performed in order to improve quality of life. Even if resection was achieved in free margins, “local” relapse was observed 5 months after surgery. PMID:25386373

  17. Fetal t(5p;21q) misdiagnosed as monosomy 21: A plea for in situ hybridization studies

    SciTech Connect

    Gill, P.; Uhrich, S.; Cheng, E.; Disteche, C. [Univ. of Washington Medical Center, Seattle, WA (United States)

    1994-10-01

    We report a case of 45,XY,-5,-21,+der (5)t(5;21) (p13 or p14;q11.2 or q21) that was prenatally misdiagnosed as complete monosomy 21 and terminated at 24 weeks of gestation. Subsequent fluorescence in situ hybridization studies with a chromosome 21 painting probe documented the cryptic unbalanced translocation. 17 refs., 2 figs., 1 tab.

  18. Efficacy of inosine pranobex oral therapy in subclinical human papillomavirus infection of the vulva: a randomized double-blinded placebo controlled study.

    PubMed

    Tay, S K

    1996-07-01

    A randomized double-blind placebo controlled study was carried out to assess the efficacy of inosine pranobex (1 g orally 3 times a day for 6 weeks) in the treatment of symptomatic subclinical human papillomavirus infection of the vulva. In a series of 55 women, 22 patients in the inosine pranobex group and 24 patients in the placebo group were suitable for analysis. A total of 14 (63.5%) of the inosine pranobex treated patients and 4 (16.7%) of the placebo treated patients showed significant vulval epithelial morphological improvement (P = 0.005) at 2 months after initiation of treatment. Whereas 13 (59.1%) and 9 (37.5%) patients in the respective groups showed significant improvement in the severity of pruritus vulvae (P = 0.435). Twelve (66.7%) of 18 patients with morphological improvement compared to 10 (35.7%) of 28 patients with no morphological improvement experienced significant symptomatic alleviation of pruritus vulvae (P = 0.041). Similar results were seen at the second assessment 4 months after the initiation of treatment. Adverse drug reactions were reported by 2 patients in the treatment group and by 2 patients (skin rash) in the placebo group. These adverse reactions were mild and self limiting. It is concluded that inosine pranobex demonstrated a significant pharmacological activity in subclinical HPV infection of the vulva and should be considered an alternative treatment for the condition. PMID:8876359

  19. Successful treatment of malignant rhabdoid tumor of the vulva in an older patient: a case report and review of the literature

    Microsoft Academic Search

    Argyrios Tzilinis; Leon E Clarke; Cristina Affuso; John Fessenden

    2002-01-01

    PURPOSE: Malignant rhabdoid tumor (MRT) of the vulva is a rare and very aggressive neoplasm. Only 7 cases have been reported thus far in the English literature. This case reports the oldest patient to date with MRT. This 63 year old was successfully treated with surgery and radiation therapy. The current literature is reviewed, and different treatment modalities are considered

  20. Serum vitamin A and E levels in patients with lichen sclerosus and carcinoma of the vulva--effect of oral etretinate treatment.

    PubMed

    Romppanen, U; Tuimala, R; Punnonen, R; Koskinen, T

    1985-01-01

    Serum vitamin A and E concentrations were determined in six patients with vulvar epithelial carcinoma and in 25 patients with lichen sclerosus and atrophicus (LSA) of the vulva. No difference could be found in these levels between the two groups. LSA patients received oral etretinate for two months at least; improvement was observed in 93% of the patients. Etretinate therapy had no effect on the serum levels of vitamins A or E. PMID:3863527

  1. The caenorhabditis elegans CDT-2 ubiquitin ligase is required for attenuation of EGFR signalling in vulva precursor cells

    PubMed Central

    2010-01-01

    Background Attenuation of the EGFR (Epidermal Growth Factor Receptor) signalling cascade is crucial to control cell fate during development. A candidate-based RNAi approach in C. elegans identified CDT-2 as an attenuator of LET-23 (EGFR) signalling. Human CDT2 is a component of the conserved CDT2/CUL4/DDB1 ubiquitin ligase complex that plays a critical role in DNA replication and G2/M checkpoint. Within this complex, CDT2 is responsible for substrate recognition. This ubiquitin ligase complex has been shown in various organisms, including C. elegans, to target the replication-licensing factor CDT1, and the CDK inhibitor p21. However, no previous link to EGFR signalling has been identified. Results We have characterised CDT-2's role during vulva development and found that it is a novel attenuator of LET-23 signalling. CDT-2 acts redundantly with negative modulators of LET-23 signalling and CDT-2 or CUL-4 downregulation causes persistent expression of the egl-17::cfp transgene, a marker of LET-23 signalling during vulva development. In addition, we show that CDT-2 physically interacts with SEM-5 (GRB2), a known negative modulator of LET-23 signalling that directly binds LET-23, and provide genetic evidence consistent with CDT-2 functioning at or downstream of LET-23. Interestingly, both SEM-5 and CDT-2 were identified independently in a screen for genes involved in receptor-mediated endocytosis in oocytes, suggesting that attenuation of LET-23 by CDT-2 might be through regulation of endocytosis. Conclusions In this study, we have shown that CDT-2 and CUL-4, members of the CUL-4/DDB-1/CDT-2 E3 ubiquitin ligase complex attenuate LET-23 signalling in vulval precursor cells. In future, it will be interesting to investigate the potential link to endocytosis and to determine whether other signalling pathways dependent on endocytosis, e.g. LIN-12 (Notch) could be regulated by this ubiquitin ligase complex. This work has uncovered a novel function for the CUL-4/DDB-1/CDT-2 E3 ligase that may be relevant for its mammalian oncogenic activity. PMID:20977703

  2. Prognostic factors for groin node metastasis in squamous cell carcinoma of the vulva (a Gynecologic Oncology Group study)

    PubMed

    Homesley, H D; Bundy, B N; Sedlis, A; Yordan, E; Berek, J S; Jahshan, A; Mortel, R

    1993-06-01

    From 1977 to 1984 the Gynecologic Oncology Group (GOG) conducted a prospective clinical and surgical staging protocol of squamous cell carcinoma of the vulva (n = 637). The patients with superficial (5 mm or less invasion) lesions were the subject of a previous report (n = 272). The subject of this report is on factors that predict groin node metastasis based on all 588 evaluable patients. Comparisons between the two reports are made. Almost half of this group (49.3%) had minimal tumor thickness (< or = mm). Almost one-third of patients had small vulvar lesions (< or = cm). Groin node metastasis was 18.9% for the < or = 2-cm diameter tumors and 41.6% for the > 2-cm diameter lesions. The inaccuracy of clinical palpation of the groin nodes (23.9% false negative) largely accounts for underestimation of extent of disease. Body weight was not related to the sensitivity of detecting positive groin nodes (P = 0.26). Using the logistic model, independent predictors of positive groin nodes were identified (in order of importance): less tumor differentiation by GOG criteria (P < 0.0001), suspicious or fixed/-ulcerated nodes (P < 0.0001), presence of capillary-lymphatic involvement (P < 0.0001), older age (P = 0.0002), and greater tumor thickness (invasion) (P = 0.03). Lesion size and location were not independent predictors of positive groin nodes. PMID:8314530

  3. Nonlesions, misdiagnoses, missed diagnoses, and other interpretive challenges in fish histopathology studies: a guide for investigators, authors, reviewers, and readers

    USGS Publications Warehouse

    Wolf, Jeffrey C.; Baumgartner, Wes A.; Blazer, Vicki S.; Camus, Alvin C.; Engelhardt, Jeffrey A.; Fournie, John W.; Frasca, Salvatore, Jr.; Groman, David B.; Kent, Michael L.; Khoo, Lester H.; Law, Jerry M.; Lombardini, Eric D.; Ruehl-Fehlert, Christine; Segner, Helmut E.; Smith, Stephen A.; Spitsbergen, Jan M.; Weber, Klaus; Wolfe, Marilyn J.

    2015-01-01

    Differentiating salient histopathologic changes from normal anatomic features or tissue artifacts can be decidedly challenging, especially for the novice fish pathologist. As a consequence, findings of questionable accuracy may be reported inadvertently, and the potential negative impacts of publishing inaccurate histopathologic interpretations are not always fully appreciated. The objectives of this article are to illustrate a number of specific morphologic findings in commonly examined fish tissues (e.g., gills, liver, kidney, and gonads) that are frequently either misdiagnosed or underdiagnosed, and to address related issues involving the interpretation of histopathologic data. To enhance the utility of this article as a guide, photomicrographs of normal and abnormal specimens are presented. General recommendations for generating and publishing results from histopathology studies are additionally provided. It is hoped that the furnished information will be a useful resource for manuscript generation, by helping authors, reviewers, and readers to critically assess fish histopathologic data.

  4. Nonlesions, misdiagnoses, missed diagnoses, and other interpretive challenges in fish histopathology studies: a guide for investigators, authors, reviewers, and readers.

    PubMed

    Wolf, Jeffrey C; Baumgartner, Wes A; Blazer, Vicki S; Camus, Alvin C; Engelhardt, Jeffery A; Fournie, John W; Frasca, Salvatore; Groman, David B; Kent, Michael L; Khoo, Lester H; Law, Jerry M; Lombardini, Eric D; Ruehl-Fehlert, Christine; Segner, Helmut E; Smith, Stephen A; Spitsbergen, Jan M; Weber, Klaus; Wolfe, Marilyn J

    2015-04-01

    Differentiating salient histopathologic changes from normal anatomic features or tissue artifacts can be decidedly challenging, especially for the novice fish pathologist. As a consequence, findings of questionable accuracy may be reported inadvertently, and the potential negative impacts of publishing inaccurate histopathologic interpretations are not always fully appreciated. The objectives of this article are to illustrate a number of specific morphologic findings in commonly examined fish tissues (e.g., gills, liver, kidney, and gonads) that are frequently either misdiagnosed or underdiagnosed, and to address related issues involving the interpretation of histopathologic data. To enhance the utility of this article as a guide, photomicrographs of normal and abnormal specimens are presented. General recommendations for generating and publishing results from histopathology studies are additionally provided. It is hoped that the furnished information will be a useful resource for manuscript generation, by helping authors, reviewers, and readers to critically assess fish histopathologic data. PMID:25112278

  5. Fatal Case of Brucellosis Misdiagnosed in Early Stages of Brucella suis Infection in a 46-Year-Old Patient with Marfan Syndrome

    PubMed Central

    Carrington, M.; Choe, U.; Ubillos, S.; Stanek, D.; Campbell, M.; Wansbrough, L.; Lee, P.; Churchwell, G.; Rosas, K.; Zaki, S. R.; Drew, C.; Paddock, C. D.; DeLeon-Carnes, M.; Guerra, M.; Hoffmaster, A. R.; Tiller, R. V.

    2012-01-01

    We report a fatal case of Brucella suis endocarditis initially misdiagnosed by automated identification systems as Ochrobactrum anthropi infection in a patient with a history of Marfan syndrome and recreational feral swine hunting. This report emphasizes the need to consider brucellosis as a part of the differential diagnosis of acute febrile illness, particularly in patients with known risk of exposure. PMID:22495564

  6. Fatal case of brucellosis misdiagnosed in early stages of Brucella suis infection in a 46-year-old patient with Marfan syndrome.

    PubMed

    Carrington, M; Choe, U; Ubillos, S; Stanek, D; Campbell, M; Wansbrough, L; Lee, P; Churchwell, G; Rosas, K; Zaki, S R; Drew, C; Paddock, C D; Deleon-Carnes, M; Guerra, M; Hoffmaster, A R; Tiller, R V; De, B K

    2012-06-01

    We report a fatal case of Brucella suis endocarditis initially misdiagnosed by automated identification systems as Ochrobactrum anthropi infection in a patient with a history of Marfan syndrome and recreational feral swine hunting. This report emphasizes the need to consider brucellosis as a part of the differential diagnosis of acute febrile illness, particularly in patients with known risk of exposure. PMID:22495564

  7. Posterior microphthalmos and papillomacular fold-associated cystic changes misdiagnosed as cystoid macular edema following cataract extraction

    PubMed Central

    Albar, Ahmad A; Nowilaty, Sawsan R; Ghazi, Nicola G

    2015-01-01

    Purpose Novel spectral-domain optical coherence tomography (SD-OCT) findings in posterior microphthalmos (PM) include cystoid changes in the papillomacular fold (PMF). These changes may be misdiagnosed as cystoid macular edema (CME) and may trigger unnecessary treatment including intravitreal injections. We report a case that underscores this scenario aiming to increase awareness of this entity among ophthalmologists. Method A case report. Results A 25-year-old male presented with a history of clear lens extraction in both eyes as a refractive procedure. Postoperatively, he was diagnosed with CME and received five intravitreal bevacizumab injections in each eye as well as oral diamox for persistent cystic spaces noted on OCT. He was referred to our institution with the diagnosis of non-responding CME. A complete ophthalmic evaluation, including ultrasonography and SD-OCT, confirmed the diagnosis of PM and PMF with cystic cavities in the PMF. A fluorescein angiogram disclosed absence of macular leakage or optic nerve head staining indicating that the cystic cavities seen on SD-OCT are not due to postoperative CME but are rather the intrinsic cystic changes commonly seen in eyes with PM and a PMF. These cystic cavities were incorrectly thought to represent postoperative CME, which triggered the unnecessary treatment and lack of response. Conclusion Cystic-like cavities are a component of the PMF in PM eyes and may be misdiagnosed as CME, especially in a postoperative setting. This case underscores the importance of understanding the intrinsic features of the PMF in eyes with PM and may help increase awareness among ophthalmologists of such a potentially confusing scenario. PMID:25609908

  8. Different DNA damage and cell cycle checkpoint control in low- and high-risk human papillomavirus infections of the vulva.

    PubMed

    Santegoets, Lindy A M; van Baars, Romy; Terlou, Annelinde; Heijmans-Antonissen, Claudia; Swagemakers, Sigrid M A; van der Spek, Peter J; Ewing, Patricia C; van Beurden, Marc; van der Meijden, Willem I; Helmerhorst, Theo J M; Blok, Leen J

    2012-06-15

    Human papillomavirus (HPV) infections may result in benign hyperplasia, caused by low-risk HPV types, or (pre)malignant lesions caused by high-risk HPV types. The molecular basis of this difference in malignant potential is not completely understood. Here, we performed gene profiling of different HPV infected vulvar tissues (condylomata acuminata (n = 5), usual type vulvar intraepithelial neoplasia (uVIN) (n = 9)) and control samples (n = 14) using Affymetrix Human U133A plus 2 GeneChips. Data were analyzed using OmniViz®, Partek® and Ingenuity® Software. Results were validated by real-time RT-PCR and immunostaining. Although similarities were observed between gene expression profiles of low- and high-risk HPV infected tissues (e.g., absence of estrogen receptor in condylomata and uVIN), high-risk HPV infected tissues showed more proliferation and displayed more DNA damage than tissues infected with low-risk HPV. These observations were confirmed by differential regulation of cell cycle checkpoints and by increased expression of DNA damage-biomarkers p53 and ?H2AX. Furthermore, FANCA, FANCD2, BRCA1 and RAD51, key players in the DNA damage response, were significantly upregulated (p < 0.05). In addition, we compared our results with publicly available gene expression profiles of various other HPV-induced cancers (vulva, cervix and head-and-neck). This showed p16(INK4a) was the most significant marker to detect a high-risk HPV infection, but no other markers could be found. In conclusion, this study provides insight into the molecular basis of low- and high-risk HPV infections and indicates two main pathways (cell cycle and DNA damage response) that are much stronger affected by high-risk HPV as compared to low-risk HPV. PMID:21815142

  9. Lymphatic Mapping and Sentinel Lymph Node Biopsy in Women With Squamous Cell Carcinoma of the Vulva: A Gynecologic Oncology Group Study

    PubMed Central

    Levenback, Charles F.; Ali, Shamshad; Coleman, Robert L.; Gold, Michael A.; Fowler, Jeffrey M.; Judson, Patricia L.; Bell, Maria C.; De Geest, Koen; Spirtos, Nick M.; Potkul, Ronald K.; Leitao, Mario M.; Bakkum-Gamez, Jamie N.; Rossi, Emma C.; Lentz, Samuel S.; Burke, James J.; Van Le, Linda; Trimble, Cornelia L.

    2012-01-01

    Purpose To determine the safety of sentinel lymph node biopsy as a replacement for inguinal femoral lymphadenectomy in selected women with vulvar cancer. Patients and Methods Eligible women had squamous cell carcinoma, at least 1-mm invasion, and tumor size ? 2 cm and ? 6 cm. The primary tumor was limited to the vulva, and there were no groin lymph nodes that were clinically suggestive of cancer. All women underwent intraoperative lymphatic mapping, sentinel lymph node biopsy, and inguinal femoral lymphadenectomy. Histologic ultra staging of the sentinel lymph node was prescribed. Results In all, 452 women underwent the planned procedures, and 418 had at least one sentinel lymph node identified. There were 132 node-positive women, including 11 (8.3%) with false-negative nodes. Twenty-three percent of the true-positive patients were detected by immunohistochemical analysis of the sentinel lymph node. The sensitivity was 91.7% (90% lower confidence bound, 86.7%) and the false-negative predictive value (1-negative predictive value) was 3.7% (90% upper confidence bound, 6.1%). In women with tumor less than 4 cm, the false-negative predictive value was 2.0% (90% upper confidence bound, 4.5%). Conclusion Sentinel lymph node biopsy is a reasonable alternative to inguinal femoral lymphadenectomy in selected women with squamous cell carcinoma of the vulva. PMID:22753905

  10. Clinical analysis of a patient with a benign lesion of the pharynx misdiagnosed as functional thyroid cancer metastasis

    PubMed Central

    WANG, RENFEI; TAN, JIAN; ZHANG, GUIZHI; JIA, QIANG

    2015-01-01

    Papillary thyroid carcinoma (PTC) usually has a lower malignancy rate and better prognosis than other types of thyroid cancer. It tends to spread through the lymphatic system, and the percentage of lymph node metastasis to the neck is 50–70% in patients at the time of diagnosis. Iodine-131 (131I) whole-body scanning is very valuable in the diagnosis and positioning of functional metastatic lesions. However, a variety of comprehensive test results are frequently required to make an appropriate judgment. The present case report describes the case of a patient with PTC where a benign lesion of the pharynx was misdiagnosed as functional metastasis. Some remnant thyroid tissue and an abnormal accumulation of 131I in the oropharynx and at the right side of the neck were observed by 131I whole-body scanning one week after the first therapeutic dose. Following the second therapeutic dose, quasi-circular trapping of 131I by the pharynx persisted. Magnetic resonance imaging enhanced scanning of the oropharynx showed markedly uneven enhancement inside the lesion, and it was considered as a metastatic lesion. However, the serological test results of the patient revealed that there was no increase in the thyroglobulin level and did not support the diagnosis of progressive disease. Therefore, a biopsy on the lesion was conducted under local anesthesia. The histopathological examination exhibited salivary gland tissue and chronic inflammation. Thus, it was necessary to analyze the imaging results, as well as serologic testing outcomes and pathological findings comprehensively, in order to make the correct diagnosis.

  11. CO2 laser ablation of external genital lesions with a SwiftLase flashscanner: treatment of extramammary Paget's disease of the vulva, penile condylomata, and other lesions

    NASA Astrophysics Data System (ADS)

    Sacknoff, Eric J.; Schweitzer, Jay; Slatkine, Michael; Mead, Douglass S.

    1995-05-01

    The ability to vaporize extremely thin layers of epithelial tissue without any char and with minimal thermal necrosis is extremely advantageous in the treatment of superficial lesions of the external genitalia. We present a novel CO2 laser `SwiftLase' flashscan technology capable of providing char free ablation of 3 mm diameter lesions with only 150 micron residual thermal necrosis depth at power level as low as 10 watts. These power levels are achievable with a small transportable CO2 laser. The SwiftLaser is a miniature opto- mechanical scanner which homogeneously covers a 3 mm diameter surface with a 0.1 mm spot size focused beam within 0.1 seconds. The instantaneous beam's dwelling time is 1 millisecond. The instantaneous power density level at the focal point is higher than the threshold for char free ablation, thus providing a large char free ablation crater. Since depth of each ablated layer is 0.1 mm, the depth of treatment can be precisely controlled. The SwiftLaser technology has extensively and successfully been used in the last two years for the treatment of HPV in female lower tracts (Vulvectomy). The same technique may be performed with extramammary Paget's disease of the vulva, penile condylomata, and other epithelial disorders of the external genitalia without damage to surrounding healthy tissue. Technique and clinical results will be discussed.

  12. Epidermolytic hyperkeratosis of the vulva associated with basal cell carcinoma in a patient with vaginal condyloma acuminatum and vaginal intraepithelial neoplasia harboring HPV, type 42.

    PubMed

    Kacerovská, Denisa; Michal, Michal; Kašpírková, Jana; Kazakov, Dmitry V

    2014-04-01

    The occurrence of basal cell carcinoma (BCC) of the vulva is rare. We report the case of a 79-year-old woman with a medical history of intravaginal condyloma acuminatum and vaginal intraepithelial neoplasia 3 (VaIN 3) who presented with a solitary whitish lesion sized 8x5 mm with a central desquamation located on the right labium majus. Histopathologic examination revealed a typical superficial and nodular BCC. Additionally, there were multiple remarkable foci of epidermolytic hyperkeratosis (EH). These foci both merged with superficial BCC or were sharply demarcated from the tumor. Retrospective molecular-biological examination of all the available material revealed HPV type 42 in both condyloma acuminatum and VaIN 3 specimen but not in the BCC associated with EH. To our best knowledge, involvement of the lower female genitalia by EH is a rare finding with six cases published to date. Awareness of EH in this location and its distinction is important because it may be potentially misinterpreted as a viral condyloma. PMID:24758505

  13. Squamous Cell Carcinoma of the Vulva: A Subclassification of 97 Cases by Clinicopathologic, Immunohistochemical, and Molecular Features (p16, p53, and EGFR).

    PubMed

    Dong, Fei; Kojiro, Sakiko; Borger, Darrell R; Growdon, Whitfield B; Oliva, Esther

    2015-08-01

    Squamous cell carcinomas (SCCs) of the vulva develop through human papilloma virus (HPV)-associated or HPV-independent pathways, but the relationship between pathogenesis, classification, and prognosis of these tumors is controversial. Therefore, we review the morphology, immunophenotype, and select molecular features of a consecutive series of 97 patients with vulvar SCC with a median clinical follow-up of 3.6 years. Tumors were histologically classified as basaloid (13), warty (11), mixed basaloid and warty (1), keratinizing (68), nonkeratinizing (3), and sarcomatoid (1). Diffuse p16 expression was associated with younger age at presentation (P<0.0001), basaloid and warty carcinoma subtypes (P<0.0001), and usual vulvar intraepithelial neoplasia (P<0.0001) and was negatively associated with p53 immunopositivity (P=0.0008). Five keratinizing SCCs showed p16 and p53 coexpression, but only 1 was positive for high-risk HPV by in situ hybridization. Among 8 of 36 tumors with EGFR gene amplification, 4 were p53 positive but none p16 positive. In a Cox regression model, early clinical stage (P<0.006), p16 expression (P=0.002), and absent p53 expression (P=0.02) were independent predictors of improved overall survival. These findings utilize morphologic and immunohistochemical analysis to support HPV-associated and HPV-independent pathogenesis of vulvar SCCs and support p16 and p53 immunohistochemistry as markers of disease biology and clinical outcome. PMID:26171917

  14. Giant cell angiofibroma misdiagnosed as a vascular malformation and treated with absolute alcohol for one year: a case report and review of the literature

    PubMed Central

    2014-01-01

    Purpose To present the clinical, imaging, pathological and immunohistochemical features of giant cell angiofibroma (GCA). Case presentation In this paper we report an atypical case of a GCA extending from the parotid to the parapharyngeal space. The lesion was being treated as a vascular malformation for one year prior to surgical removal. We summarize the clinical manifestations, imaging, pathological and molecular features of this rare disease. After complete surgical removal of the tumor, immunohistochemical analysis revealed strong positivity for the mesenchymal markers vimentin, CD34, CD31 and CD99 in neoplastic cells. Tumor proliferation antigen marker Ki67 was partly positive (<5% of cells). Tumor cells were negative for muscle-specific actin, epithelial membrane antigen, smooth muscle actin, cytokeratin pan, S100, desmin, glial fibrillary acidic protein, myogenin, MyoD1 and F8. The morphological and immunohistochemical profile was consistent with the diagnosis of GCA. Conclusion GCA is a rare soft tissue tumor that can easily be misdiagnosed in the clinical preoperative setting. In view of the clinical, pathological and molecular features of the tumor, complete surgical removal is the current optimal treatment option, providing accurate diagnosis and low to minimal recurrence rate. PMID:24758544

  15. [A case of invasive ductal carcinoma of the pancreas originating from an intraductal papillary mucinous tumor that was initially misdiagnosed as a mucinous cystic tumor].

    PubMed

    Yokoyama, Shigekazu; Sasaki, Yo; Hashimoto, Kazuhiko; Takeda, Mitsunobu; Toshiyama, Reishi; Fukuda, Shuichi; Naito, Atsushi; Matsumoto, Shinji; Tokuoka, Masayoshi; Ide, Yoshihito; Matsuyama, Jin; Morimoto, Takashi; Fukushima, Yukio; Nomura, Takashi; Kodama, Ken; Shiba, Ikue; Takeda, Masashi

    2012-11-01

    A 57-year-old woman was discovered to have a cystic tumor, 8 cm in diameter, at the pancreas tail, during routine screening with ultrasonography. The patient did not complain of tenderness, and no abdominal mass was palpable at physical examination. Enhanced computed tomography(CT) revealed that the tumor had mural nodules in the cyst wall, and we suspected it to be a malignant tumor that had occurred in the mucinous cystic neoplasm(MCN). Therefore, surgical resection was attempted, upon which the tumor was found to be hard and the surrounding tissue adhered widely to the stomach. We separated it carefully from the stomach and then performed a distal pancreatectomy. The cut surface revealed that the posterior wall of the cystic tumor was partly thickened, and microscopic examination revealed it to be invasive ductal carcinoma. No ovarian-like stroma was involved and some degree of dysplasia(PanIN 1-3) was found in the neighboring tissues. Therefore, we re-diagnosed it to be invasive ductal carcinoma of the pancreas derived from intraductal papillary mucinous tumor(IPMT), not from MCN. The patient received adjuvant chemotherapy, although 5 months later multiple lung metastases had appeared. The international consensus guidelines for management of IPMN and MCN of the pancreas suggest that they can usually be distinguished preoperatively, if there is a complete understanding of their clinical and imaging features. However, we sometimes find it difficult to distinguish the 2, because some IPMN or MCN cases have shared preoperative features. Herein, we report the case of invasive ductal carcinoma of the pancreas derived from IPMT that was originally misdiagnosed as a MCN. PMID:23268006

  16. Small Cell Carcinoma of Vulva

    Microsoft Academic Search

    Franziska Eckert; Tanja Fehm; Michael Bamberg; Arndt-Christian Müller

    2010-01-01

    \\u000a Abstract\\u000a \\u000a \\u000a Background and Purpose:\\u000a   Extrapulmonary small cell carcinoma (EPSCC) is a rare disease, which has a slightly better prognosis than small cell lung\\u000a cancer, but still dismal. Gynecologic small cell malignancies tend to show a better survival than similar histologies of other\\u000a regions. However, of five reported cases of vulvar manifestation only one patient was disease-free at the time of

  17. [KAPOSI'S SARCOMA OF THE VULVA].

    PubMed

    Chokoeva, Aa; Tchernev, G; Wollina, U

    2015-01-01

    Kaposi's sarcoma represents multiple idiopathic hemorrhagic sarcoma--a mesenchymal tumor that affects the blood and lymph vessels. Its performance is associated with an infection with human herpes virus type 8--the so called KSHV (Kaposi's sarcoma -associated virus), and with the human immunodeficiency virus. Kaposi's sarcoma is considered as a typical clinical manifestation in male homosexuals suffering from acquired immune deficiency syndrome (AIDS), while his performance in HIV-positive women is unusual, with a ratio of men to women--10-15: 1. Vulvar localization is much rarer. It is up to 5 times more frequent in HIV- positive patients. It is clinically represented in most of the cases by the clinical picture of nonspecific tumor mass. Biopsy and further virological testing for establishing KSHV in lesional tissue is essential for confirming the diagnosis. Serological testing for HIV/AIDS in affected patients is required. Local treatment includes surgical excision of solitary lesions, cryotherapy as well as radiotherapy. The use of interferon alpha resulted in complete remission in approximately 40% of the affected patients. New trends in treatment tend to be pathogenetically directed as in the process of studies to date are inhibitors of angiogenesis. Due to the rarity of the occurrence, non-specific clinical picture and histological findings, Kaposi's sarcoma should be considered in the differential diagnosis of tumor masses with vulvar localization, especially in HIV-positive patients. PMID:26137776

  18. Vulval dermatoses

    Microsoft Academic Search

    Elizabeth K. Derrick; Sallie Neill

    2010-01-01

    Dermatological disorders in the vulva are common. They are often misdiagnosed and mistreated because of the patient's delay in seeking help, or the doctor's failure to examine the area and inadequate training in anogenital diseases. Knowledge of the anatomy and appearance of the normal vulva is essential in order to recognize any abnormality or disease. Common skin diseases (eczema and

  19. Sparganosis in Russell's viper snake: a case report.

    PubMed

    Kavitha, K T; Latha, B R; Bino Sundar, S T; Sridhar, R; Abdul Basith, S

    2014-12-01

    The occurrence of the plerocercoid larva, Sparganum of Sparganum spp. in two Russell's viper snakes maintained in Chennai snake park trust, Chennai is reported for the first time from Southern India. The cestode larvae were found in the sub cutis and were flat, solid, wrinkled, ribbon like creamy white in colour with peudosegmentation with anterior end possessing bothria. The cuticles, subcuticular cells and parenchymatous tissue stained by acetic alum carmine further confirmed the cestode larvae. PMID:25320490

  20. Idiopathic Calcinosis Cutis of the Vulva

    PubMed Central

    Coban, Yusuf K; Aytekin, Ahmet H; Aydin, Engin N

    2013-01-01

    Background: In the present study, calcinosis cutis (CC) is defined as the deposition of amorphous calcium and phosphate salts under epidermis and it may be caused by a pre-existing event such as extravasation injury or hypercalcemic conditions. Idiopathic CC cases have no underlying disease or pre-existing cause. Aim: A demostrative vulvar idiopathic CC case presentation and review of the related literature. Methods: A 42-year-old multiparous female presented with vulvar nodular masses. She was keen on surgical removal of the lesions, as the masses caused dyscomfort during sexual intercourse. The lesions were removed and sent for histopathological examination. There was neither a history of trauma nor any inflammatory process in the vulvar skin prior to the development of lesions and no systemic abnormality was detected. Results and Conclusions: The histhopathologic evaluation of the biopsy specimen showed amorphous calcium deposits without any inflammatory infiltration in the dermis. There was no recurrence at 1 year's follow-up. This case shows that idiopathic CC may develop slowly at labio-vulvar region in a sexually active female with normal systemic or laboratory findings PMID:24249900

  1. Cerebral Vein Thrombosis Misdiagnosed and Mismanaged

    PubMed Central

    Sasidharan, P. K.

    2012-01-01

    Cerebral venous thrombosis (CVT) should be considered in the differential diagnosis of all unexplained CNS disorders of sudden onset. Etiological factors are often subclinical forms of several common thrombophilic states occurring together, rather than the typical inherited and rare causes. Diagnosis is missed because of the heterogeneity in clinical presentation and etiological factors. In several patients with the so called idiopathic CVT nutritional deficiencies and lifestyle issues are more important factors in pathogenesis, rather than single rarer causes. High index of suspicion is the key to diagnosis. Clinical skill has to be fine tuned to diagnose the problem and to identify all the etiological factors. Radiology is essential for diagnosis but relying on radiology alone will lead to missing several cases and even erroneous diagnosis. It is inappropriate to proceed prematurely to laboratory investigations, forgetting proper clinical evaluation by studying diet, lifestyle, and environment of the patients. Success in managing lies in identifying all the contributory causes and correcting all of them giving excellent outcome almost always. Clinical observations based on case series and sharing of such information alone are the means to arrive at a consensus in diagnosis and management. PMID:22567255

  2. Methamphetamine Ingestion Misdiagnosed as Centruroides sculpturatus Envenomation

    PubMed Central

    Strommen, Joshua; Shirazi, Farshad

    2015-01-01

    The authors present a case report of a 17-month-old female child who ingested a large amount of methamphetamine that looked very similar clinically to a scorpion envenomation specific to the southwestern United States by the species Centruroides sculpturatus. The child was initially treated with 3 vials of antivenom specific for that scorpion species and showed a transient, though clinically relevant neurologic improvement. Her clinical course of sympathomimetic toxicity resumed and she was treated with intravenous fluids and benzodiazepines after blood analysis showed significant levels of d-methamphetamine. This case report is to specifically underline the clinical confusion in discerning between these two conditions and the realization of limited and/or expensive resources that may be used in the process. PMID:25649670

  3. Vulval dermatoses

    Microsoft Academic Search

    EK Derrick; Sallie Neill

    2005-01-01

    Vulval dermatoses are common and can cause significant symptoms. Any generalized skin disorder may affect the anogenital area, but the most common are eczema and psoriasis. Other dermatoses preferentially affect the vulva (e.g. lichen sclerosus, lichen planus). Itching and soreness are the most common symptoms. Many women are not examined and are misdiagnosed with ‘thrush’. Self-treatment with topical medications may

  4. Recurrent aggressive angiomyxoma of the vulva - a rare presentation.

    PubMed

    Sengupta, Sandip Kumar; Bhattacharyya, Sanjay Kumar; Saha, Shyama Prasad; Roy, Hironmoy; Sarkar, Amarendra Nath

    2014-05-01

    We describe here a case of a 38-year-old lady presenting with a about 5x4cm in size swelling on the left labia majora. She had similar type of swelling 2 years back which was treated surgically. FNAC report of the present mass revealed angiomyxoma. In view of its' recurrent nature wide local surgical excision of the mass was done. Histopathology report confirmed the diagnosis of angiomyxoma. The lady is under follow up and there is no further recurrence till date. PMID:24995218

  5. A misdiagnosed burn: necrotising fasciitis in an elderly patient

    PubMed Central

    Vijayan, Roshan; Magdum, Ashish; Critchley, Paul

    2013-01-01

    A 91-year-old man was admitted having been found unresponsive in his bed. He was previously well, but had sustained a laceration over the dorsum of his forearm after a recent fall. Initial appearances were innocuous, and suggestive of a superficial wound infection. A review of the wound by the plastic surgeons led to the diagnosis of a full-thickness burn, despite a lack of supporting evidence in the history. No clinician who had initially assessed the patient was involved in his ongoing care. Rapid clinical deterioration ensued, with sepsis and deteriorating mental state. Necrosis spread rapidly up his arm, and the diagnosis of necrotising fasciitis was made. The patient was urgently taken to theatre for circumferential excision of the necrotic tissue. He was subsequently managed on the intensive care unit where he made a promising initial recovery, but later died from pneumonia in the ward. PMID:23833100

  6. Paederus dermatitis: an easy diagnosable but misdiagnosed eruption.

    PubMed

    Gelmetti, C; Grimalt, R

    1993-01-01

    Paederus dermatitis is a peculiar irritant contact dermatitis characterised by erythemato-bullous lesions of sudden onset on exposed areas of the body. The disease is provoked by an insect belonging to genus Paederus. This beetle does not bite or sting, but accidental brushing against or crushing the beetle over the skin provokes the release of its coelomic fluid which contains paederin, a potent vesicant agent. Due to the pathogenic mechanism, the morphology and location of the dermatitis change from case to case. The lesion usually resembles the accidental dropping of a caustic or hot liquid. The uncommon association of acute dermatitis with minimal or no complaints, which would be noteworthy in the case of chemical or thermal burns, facilitates diagnosis which is corroborated by the season and by the case history. PMID:8444208

  7. Neurological adverse effects of methylphenidate may be misdiagnosed as meningoencephalitis.

    PubMed

    Snell, Luke Blagdon; Bakshi, Dinkar

    2015-01-01

    We present a case of adverse neurological effects of methylphenidate therapy for attention deficit and hyperactivity disorder (ADHD). A 7-year-old boy presented to the emergency department (ED) having developed ataxic gait, orofacial dyskinesias and choreoathetosis of the limbs. The results of all blood investigations, EEG and CT scan of the head were unremarkable. Subsequently, a detailed history revealed he was being treated for ADHD, being started on methylphenidate in the past 3?months. Discontinuation of methylphenidate led to significant and rapid amelioration of neurological adverse effects. PMID:26082097

  8. Teaching neuroimages: neuromyelitis optica misdiagnosed as spinal cord tumor.

    PubMed

    Tsivgoulis, Georgios; Kontokostas, Stefanos; Boviatsis, Efstathios; Bonakis, Anastasios; Stefanis, Leonidas; Voumvourakis, Konstantinos

    2014-01-28

    A 17-year-old girl presented with acute-onset cervical pain, followed by left arm weakness and gait disturbances. Spinal cord astrocytoma was diagnosed by MRI performed at an outpatient facility (figure, A and B). The patient was admitted to the neurosurgery department to undergo spinal cord biopsy. A second neurologic evaluation indicated neuromyelitis optica (NMO) as the most likely diagnosis, which was confirmed by NMO-immunoglobulin G seropositivity. The patient was treated with rescue plasmapheresis with substantial clinical and radiologic (figure, C) improvement. PMID:24470607

  9. A Case of Intestinal Mastocytosis Misdiagnosed as Crohn's Disease

    PubMed Central

    Reggiani, Stefania; Cosso, Loretta; Adriani, Alessandro; Pantaleoni, Stefano; Risso, Alessandro; Vittone, Federico; Chiusa, Luigi; Sapone, Nicoletta; Astegiano, Marco

    2015-01-01

    Systemic mastocytosis (SM) is a rare, heterogeneous and progressive disease, characterized by the accumulation of atypical mast cells in various organs, including the gastrointestinal tract. Gastrointestinal symptoms are present in up to 80% of patients with SM, the most common being abdominal pain, diarrhea, nausea and vomiting. Up to 50% of patients with SM do not have classical skin lesions at presentation, and in these patients the diagnosis of SM can be difficult for years. Here we report a case of SM that initially mimicked inflammatory bowel disease, although the patient showed poor response to steroid therapy. The right diagnosis was made only on the surgical specimen obtained after emergency surgery for intestinal obstruction. SM should therefore be considered in the diagnostic approach in patients with gastrointestinal symptoms not attributable to other pathologies and in cases of suspected inflammatory bowel disease with unusual course.

  10. Atypical Guillain-Barré Syndrome Misdiagnosed as Lumbar Spinal Stenosis

    PubMed Central

    Jung, Dae Young; Lee, Seung Chul

    2013-01-01

    Guillain-Barré syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy. In typical cases, the first symptoms of GBS are pain, numbness, paresthesia, weakness in the limbs. Autonomic involvement is common and causes urinary retention and ileus. Much of these symptoms overlap with those of lumbar spinal stenosis. Therefore, correct diagnosis of GBS in a patient with symptomatic lumbar spinal stenosis or in a patient with atypical manifestations of GBS can be difficult, especially early in the course of GBS. Here, we report on a case of atypical GBS in a 74-year-old previously healthy patient with lumbar spinal stenosis and discuss the differential diagnosis of the GBS and lumbar spinal stenosis. PMID:23826482

  11. Velvet Vulvas at School: The Catalyzing Power of the Arts in Education

    ERIC Educational Resources Information Center

    Quinn, Therese

    2008-01-01

    As a teacher of art teachers, this author values and promotes an education through the arts that loves freedom, an education through art connected to powerful social ideas and movements, connected to social justice. This is not a kind of education common today in public schools, but it has a rich lineage. Drawing inspiration from Maxine Greene,…

  12. Distribution of human papillomavirus genotypes in invasive squamous carcinoma of the vulva

    Microsoft Academic Search

    Bobbie C Sutton; Richard A Allen; William E Moore; S Terence Dunn

    2008-01-01

    Many studies have established a critical role for human papillomavirus (HPV) in the development of anogenital squamous neoplasia. In this report, we show the distribution of 37 high- and low-risk HPV types in 116 cases of invasive squamous vulvar carcinoma. Sections from paraffin-embedded tissue blocks were dissected as necessary to select areas of invasive carcinoma. Clinical and pathologic variables were

  13. Misdiagnosing recurrent medulloblastoma: the danger of examination and imaging without histological confirmation.

    PubMed

    Weintraub, Lauren; Miller, Todd; Friedman, Ilana; Abbott, Rick; Levy, Adam S

    2014-01-01

    The screening and detection of recurrent medulloblastoma presents the clinician with significant diagnostic challenges, including the risk of misdiagnosis. The authors present the case of a young girl with a history of a treated standard-risk medulloblastoma that highlights the risk of assuming recurrence has occurred when clinical and/or imaging changes are observed. This girl developed both new clinical deficits and had radiographic evidence of recurrence. She subsequently experienced a complete resolution of symptoms and radiographic findings with steroids alone. PMID:24206345

  14. Longstanding Hypoparathyroidism in a Fifty-Two-Year-Old Woman Misdiagnosed as Spondyloarthropathy

    PubMed Central

    Zabihiyeganeh, Mozhdeh; Jahed, Seyed Adel; Akbari, Hounaz

    2014-01-01

    Introduction: Hypoparathyroidism might cause various musculoskeletal findings, resembling Spondyloarthropathies. Case Presentation: We described a 52-year-old woman, diagnosed as a case of undifferentiated spondyloarthropathy for ten years, who was unresponsive to classic anti-inflammatory therapies. She developed anterior ischemic optic neuropathy and had elevated muscle enzymes during the course of disease. On a routine checkup, marked hypocalcemia and suppressed parathyroid hormone levels were found. Calcium and calcitriol therapy led to clinical and laboratory improvement. Conclusions: This case emphasizes the importance of recognizing rheumatic manifestations of hypoparathyroidism to preclude unnecessary treatments. Serum calcium should be included in the diagnostic workup of these patients. PMID:25763244

  15. A foreign body of the larynx misdiagnosed as vocal cord paralysis

    PubMed Central

    Kumar, Sunil; Singh, Devendra Bahadur; Singh, Abhishek Bahadur

    2013-01-01

    Foreign bodies in the aerodigestive tract continue to be a common problem that contribute significantly to high morbidity and mortality all over the world. Laryngeal foreign bodies may present with less severe symptoms compared with lower respiratory tract foreign bodies, resulting in misdiagnosis, confusion and delay in diagnosis. Rigid endoscopy with forceps removal under general anaesthesia is the preferred management modality. This case is described to show the importance of a detailed history and examination including X-ray neck in children to rule out any radiopaque laryngeal foreign body as a delay in diagnosis and management can lead to life-threatening complications. PMID:23853027

  16. Complications arising from a misdiagnosed giant lipoma of the hand and palm: a case report

    PubMed Central

    2011-01-01

    Introduction Lipomas are benign tumors which may appear in almost any human organ. Their diagnosis rate in the hand region is not known. Case Presentation We present the case of a 63-year-old Greek Caucasian woman with a giant lipoma of the hand and palm which was not initially diagnosed. After repeated surgical decompression of the carpal tunnel the patient was referred with persisting symptoms of median and ulnar nerve compression and a prominent mass of her left palm and thenar eminence. Clinical examination, magnetic resonance imaging, nerve conduction study and biopsy, revealed a giant lipoma in the deep palmar space (8.0 × 4.0 × 3.75 cm), which was also infiltrating the carpal tunnel. She had already undergone two operations for carpal tunnel syndrome with no relief of her symptoms and she also ended up with a severed flexor pollicis longus tendon. Definitive treatment was performed by marginal resection of the lipoma and restoration of the flexor pollicis longus with an intercalated graft harvested from the palmaris longus. Thirty months after surgery the patient had a fully functional hand without any neurological deficit. Conclusion Not all lipomas of the wrist and hand are diagnosed. Our report tries to emphasize the hidden danger of lipomas in cases with carpal tunnel symptoms. The need for a high index of suspicion in conjunction with good clinical evaluation and the use of appropriate investigative studies is mandatory in order to avoid unnecessary operations and complications. Marginal excision of these tumors is restorative. PMID:22085433

  17. Q Fever with Unusual Exposure History: A Classic Presentation of a Commonly Misdiagnosed Disease

    PubMed Central

    Nett, Randall J.; Book, Earl; Anderson, Alicia D.

    2012-01-01

    We describe the case of a man presumptively diagnosed and treated for Rocky Mountain spotted fever following exposure to multiple ticks while riding horses. The laboratory testing of acute and convalescent serum specimens led to laboratory confirmation of acute Q fever as the etiology. This case represents a potential tickborne transmission of Coxiella burnetii and highlights the importance of considering Q fever as a possible diagnosis following tick exposures. PMID:22848855

  18. Persistent Genital Arousal Disorder Misdiagnosed Due to Islamic Religious Bathing Rituals: A Report of 3 Cases

    Microsoft Academic Search

    Ejder Akgun Yildirim; Munevver Hacioglu; Altan Essizoglu; Ilker Kucukparlak

    2012-01-01

    Persistent genital arousal disorder (PGAD) is not well known or adequately understood by physicians. PGAD is characterized by a persistent and highly unwanted state of genital arousal and orgasm-like feelings. “Ghusl” is an ablution in Islamic culture, which is an obligatory ritual wherein the body is washed thoroughly after exposure to “religious contaminants,” such as sexual intercourse, menstruation, and childbirth.

  19. A case of maple syrup urine disease misdiagnosed as tetanus neonatorum on admission.

    PubMed

    Kültürsay, N; Kütükçüler, N; Büyükgebiz, B; Kleijer, W J

    1994-06-01

    A case of Maple Syrup Urine Disease (MSUD) is presented with clinical signs and symptoms on admission resembling neonatal tetanus. Diagnosis had to be differentiated between MSUD and other metabolic disorders and neonatal infections (especially neonatal tetanus because of severe opisthotonos) and generalized seizures of the patient. Early diagnosis of the MSUD patient is very important for effective therapy and better long-term prognosis as well as genetic counselling and prenatal diagnosis for future pregnancies. PMID:8091979

  20. Epilepsy misdiagnosed as long QT syndrome: it can go both ways.

    PubMed

    Medford, Beth A; Bos, J Martijn; Ackerman, Michael J

    2014-01-01

    Cardiogenic seizures are common and could be the sentinel event heralding the presence of congenital long QT syndrome (LQTS). Distinguishing a cardiogenic seizure from a neurogenic one is of the utmost importance. Herein, we present the case of a 12-year-old boy with recurrent episodes of syncope and seizures. Despite absence of QT prolongation on electrocardiogram, absence of documented arrhythmias, a negative LQTS genetic test, and recurrent episodes while on nadolol beta-blocker therapy, he was diagnosed with LQTS and implanted with an implantable cardioverter defibrillator (ICD). When syncope and seizure occurred with normal sinus rhythm documented on the ICD, he was referred to neurology, and an electroencephalogram was positive for numerous bursts of bilaterally synchronous generalized discharges. He was started on antiepileptic treatment after which his seizures resolved. His LQTS diagnosis was removed, beta-blocker therapy discontinued, and his ICD was explanted. He has been seizure-free for over 2 years. PMID:23750755

  1. Delayed Surgery for Parathyroid Adenoma Misdiagnosed as a Thyroid Nodule and Treated with Radiofrequency Ablation

    PubMed Central

    Kim, Ho-Su; Choi, Bong Hoi; Park, Jung Rang; Hahm, Jong Ryeal; Jung, Jung Hwa; Kim, Soo Kyoung; Kim, Sungsu; Kim, Kyong-Young; Chung, Soon Il

    2013-01-01

    Primary hyperparathyroidism occurs as a result of isolated parathyroid adenoma in 80% to 85% of all cases. A 99mtechnetium (99mTc) sestamibi scan or neck ultrasonography is used to localize the neoplasm prior to surgical intervention. A 53-year-old female was referred for the exclusion of metabolic bone disease. She presented with low back pain that had persisted for the past 6 months and elevated serum alkaline phosphatase (1,253 IU/L). Four years previously, she had been diagnosed at a local hospital with a 2.3-cm thyroid nodule, which was determined to be pathologically benign. Radiofrequency ablation was performed at the same hospital because the nodule was still growing during the follow-up period 2 years before the visit to our hospital, and the procedure was unsuccessful in reducing the size of the nodule. The results of the laboratory tests in our hospital were as follows: serum calcium, 14.6 mg/dL; phosphorus, 3.5 mg/dL; and intact parathyroid hormone (iPTH), 1,911 pg/mL. Neck ultrasonography and 99mTc sestamibi scan detected a 5-cm parathyroid neoplasm in the left lower lobe of the patient's thyroid; left parathyroidectomy was performed. This case indicated that thyroid ultrasonographers and pathologists need to be experienced enough to differentiate a parathyroid neoplasm from a thyroid nodule; 99mTc sestamibi scan, serum calcium, and iPTH levels can help to establish the diagnosis of parathyroid neoplasm. PMID:24396684

  2. Group A Streptococci: A rare and often misdiagnosed cause of spontaneous bacterial peritonitis in adults

    PubMed Central

    Malota, Mark; Felbinger, Thomas W.; Ruppert, Reinhard; Nüssler, Natascha C.

    2014-01-01

    Introduction Acute primary peritonitis due to group A Streptococci (GAS) is a rare but life-threatening infection. Unlike other forms of primary peritonitis it affects predominantly young previously healthy individuals and thus is often confused with the more frequent secondary peritonitis. A case series of three patients is presented as well as a review of the literature focusing on pitfalls in the diagnose and therapy of GAS peritonitis. Methods A retrospective analysis of three patients with primary GAS peritonitis was performed. Furthermore a systematic review of all cases of primary GAS peritonitis published from 1990 to 2013 was performed comparing demographics and clinical presentation, as well as radiological imaging, treatment and outcome. Results All three female patients presented initially with high fever, nausea and severe abdominal pain. Radiological imaging revealed intraperitoneal fluid collections of various degrees, but no underlying cause of peritonitis. Broad antibiotic treatment was started and surgical exploration was performed for acute abdomen in all three cases. Intraoperatively fibrinous peritonitis was observed, but the correct diagnosis was not made until microbiological analysis confirmed GAS peritonitis. One patient died within 24 h after admission. The other two patients recovered after multiple surgeries and several weeks on the intensive care unit due to multiple organ dysfunction syndrome. The fulminant clinical course of the three patients resembled those of many of the published cases: flu-like symptoms, high fever, severe acute abdominal pain and fibrinous peritonitis without obvious infectious focus were the most common symptoms reported in the literature. Conclusion GAS primary peritonitis should be considered in particular in young, previously healthy women who present with peritonitis but lack radiological findings of an infectious focus. The treatment of choice is immediate antibiotic therapy. Surgical intervention is difficult to avoid, since the diagnosis of GAS peritonitis is usually not confirmed until other causes of secondary peritonitis have been excluded. PMID:25555146

  3. Cellular schwannoma arising from the gastric wall misdiagnosed as a gastric stromal tumor: A case report.

    PubMed

    Wang, Guangyao; Chen, Ping; Zong, Liang; Shi, Lei; Zhao, Wei

    2014-02-01

    Cellular schwannomas have been previously described at almost every anatomic location of the human body, but reports in the gastric wall are rare. The current study presents a rare case of cellular schwannoma originating from the gastric wall. Computed tomography revealed a 5.6×5.3×4.0-cm(3) solid mass located in the posterior wall of the stomach. Open laparotomy confirmed its mesenchymal origin. Microscopically, the tissue was composed of spindle-shaped and fascicularly-arranged cells, but mitotic figures were rare. Immunohistochemical staining showed that the tumor was negative for cluster of differentiation (CD)117, CD34, smooth muscle actin and desmin, but positive for S-100 and Ki67. The patient presented no evidence of recurrence and metastasis during follow-up. Gastric cellular schwannomas may be diagnosed by clinical characteristics, histological observations and immunohistochemical markers. PMID:24396458

  4. A case of galactosemia misdiagnosed as cow’s milk intolerance

    PubMed Central

    2012-01-01

    We report on a female patient affected by galactosemia in whom the diagnosis was obscured by the concomitant presence of manifestations suggesting a cow’s milk intolerance. This case exemplifies the problems in reaching a correct diagnosis in patients with metabolic diseases. PMID:22992216

  5. Ependymoma misdiagnosed as tuberculoma, misguided by overemphasis on MR spectroscopy in endemic area.

    PubMed

    Futane, Sameer; Salunke, Pravin; Sahoo, Sushant; Mulinani, Naveen; Vyas, Sameer

    2013-10-01

    Ependymomas and tuberculomas are common paediatric posterior fossa lesions in developing countries and may be confused with each other due to some overlapping features. The distinction is important as the treatment for each is entirely different. We have described three young children in whom clinical-radiological features and the lipid peak seen on MR spectroscopy suggested the diagnosis of posterior fossa tuberculomas. All of them were started on empirical anti-tuberculosis therapy (ATT). Increase in size/no response to anti-tuberculosis therapy was disregarded as a paradoxical response. Finally, with clinical-radiological signs worsening, surgical excision was undertaken. Histopathology revealed ependymoma in all three children. This report highlights the overdiagnosis of tuberculosis in endemic areas due to biased clinical approach compounded by false positive investigations. Tissue diagnosis, though difficult by minimally invasive methods, should be sought before initiating ATT. The attempts to establish a tissue diagnosis should be continued even after starting empirical therapy, rather than waiting for the response. PMID:23832450

  6. Acute intermittent porphyria caused by novel mutation in HMBS gene, misdiagnosed as cholecystitis

    PubMed Central

    Alfadhel, Majid; Saleh, Neam; Alenazi, Helal; Baffoe-Bonnie, Henry

    2014-01-01

    Background Acute intermittent porphyria (AIP) is an autosomal dominant neurovisceral inherited disorder due to a defect in the heme biosynthesis pathway. Misdiagnosis of the porphyrias is not uncommon. Case report We present a case of a 26-year-old female with suspected acute cholecystitis, mental status changes, and seizures. Biochemical and molecular investigations confirmed the diagnosis of AIP by findings of elevated urinary porphobilinogen, 5-aminolevulinic acid, and total porphyrins. DNA molecular testing showed a novel heterozygous mutation (c. 760delC p.L254X) in the exon11 of the HMBS gene. To the best of our knowledge, this is the first report of a misdiagnosis of AIP presenting with acute cholecystitis. Conclusion Clinicians are alerted to consider the possibility of AIP in an adult presenting with an acute abdomen, features of cholecystitis, and neuropsychiatric manifestations. PMID:25419136

  7. Unilateral Pigmented Extramammary Paget's Disease of the Axilla Associated with a Benign Mole: A Case Study and a Review of Literature

    PubMed Central

    Bramley, Maria; Titi, Sami

    2014-01-01

    Pigmented extramammary Paget's disease (PEMPD) is an uncommon intraepithelial adenocarcinoma and a rare variant of Paget's disease affecting skin that is rich in apocrine sweat glands such as the axilla, perianal region and vulva. It most commonly occurs in postmenopausal women and presents as a superficial pigmented scaly macule, mimicking a melanocytic lesion. The histological presentation is adenocarcinoma in situ with an increased number of melanocytes scattered between the Paget's cells. Therefore, PEMPD may be misdiagnosed as a melanocytic tumour both clinically and histologically. The tumour cells are usually positive for cytokeratin 7, epithelial membrane antigen, Cam 5.2, HER2, and mucicarmine stain while S100 and human melanoma black-45 highlight the processes of reactive dendritic cells. The association between Paget's cells and intratumoural reactive melanocytes is still unclear. We report our first case of PEMPD associated with an intradermal naevus involving the axilla in a 63-year-old woman. PMID:25214861

  8. Adenoid Cystic Carcinoma of Bartholin's Gland Clinically Mimics Endometriosis, A Case Report.

    PubMed

    Akbarzadeh-Jahromi, Mojgan; Sari Aslani, Fatemeh; Omidifar, Navid; Amooee, Sedigheh

    2014-11-01

    Adenoid cystic carcinoma of Bartholin's gland is a rare malignant tumor of female genital tract. We report a case of a 42-year-old woman, presenting a palpable painful mass and burning sensation on the left side of vulva during the preceding two months. Based on examination, a solid fixed painful nodule with intact mucosa was palpated on the left side of the vagina. Histological features were compatible with adenoid cystic carcinoma. Often, such lesion is clinically misdiagnosed as a cyst or inflammation. The present case was carried out with an impression of endometriosis. The possibility of cancer should be considered in any female older than 40 years of age with a lesion near the Bartholin's glands. PMID:25429183

  9. The Caenorhabditis elegans CDT2 ubiquitin ligase is required for attenuation of EGFR signalling in vulva precursor cells

    Microsoft Academic Search

    Gino B Poulin; Julie Ahringer

    2010-01-01

    BACKGROUND: Attenuation of the EGFR (Epidermal Growth Factor Receptor) signalling cascade is crucial to control cell fate during development. A candidate-based RNAi approach in C. elegans identified CDT-2 as an attenuator of LET-23 (EGFR) signalling. Human CDT2 is a component of the conserved CDT2\\/CUL4\\/DDB1 ubiquitin ligase complex that plays a critical role in DNA replication and G2\\/M checkpoint. Within this

  10. An inversion in the wiring of an intercellular signal: evolution of Wnt signaling in the nematode vulva

    E-print Network

    Paris-Sud XI, Université de

    Diversification of cells during animal development relies largely on intercellular signaling events. The signals throughout the animal kingdom. The repertoire of pathways is limited and each pathway is used in different intercellular signaling events during the development of a given animal. For example, Wnt signaling is recruited

  11. High levels of p53 expression correlate with DNA aneuploidy in (pre)malignancies of the vulva.

    PubMed

    van der Avoort, Irene A M; van de Nieuwenhof, Hedwig P; Otte-Höller, Irene; Nirmala, Ella; Bulten, Johan; Massuger, Leon F A G; van der Laak, Jeroen A W M; Slootweg, Piet J; de Hullu, Joanne A; van Kempen, Léon C L T

    2010-10-01

    The molecular pathogenesis of human papilloma virus-unrelated vulvar squamous cell carcinoma is not well known. Whether malignant progression of lichen sclerosus and differentiated vulvar intraepithelial neoplasia to vulvar squamous cell carcinoma could be accompanied by altered DNA content has not been studied extensively. DNA content in isolated nuclei of microdissected normal vulvar epithelium (n = 2), lichen sclerosus (n = 9), differentiated vulvar intraepithelial neoplasia (n = 13), and squamous cell carcinoma (n = 17) from 22 patients was measured via DNA image cytometry. For additional analysis, 6 differentiated vulvar intraepithelial neoplasia lesions were selected, bringing the number of patients to 28. p53 expression was determined by immunohistochemistry on consecutive tissue sections. Thirty-eight percent (5/13) of differentiated vulvar intraepithelial neoplasia lesions and 65% (11/17) of squamous cell carcinomas were DNA aneuploid or tetraploid. In lesions that contained differentiated vulvar intraepithelial neoplasia and adjacent squamous cell carcinoma, the ploidy status of differentiated vulvar intraepithelial neoplasia did not exceed that of squamous cell carcinoma. We observed a strong correlation between high p53 expression and DNA aneuploidy. This relation was also present at the level of a single nucleus, measured by sequential image cytometry of p53 immunohistochemistry followed by DNA image cytometry on formalin-fixed tissue sections. Similarly, we found p53-positive nonproliferating cells with increased DNA content in the superficial compartment of 6 additional solitary differentiated vulvar intraepithelial neoplasia lesions that were not associated with squamous cell carcinoma, indicating ascending aneuploid cells from the basal compartment. DNA ploidy measurements suggest that differentiated vulvar intraepithelial neoplasia has a higher malignant potential than lichen sclerosus and thus is a more likely precursor of squamous cell carcinoma. Furthermore, high p53 expression correlates with increased DNA content and aneuploidy; but it requires further research to unveil a possible causal relation. PMID:20656324

  12. Is Bilateral Lymphadenectomy For Midline Squamous Carcinoma Of The Vulva Always Necessary? An Analysis From Gynecologic Oncology Group (GOG) 173

    PubMed Central

    Coleman, Robert L.; Ali, Shamshad; Levenback, Charles F.; Gold, Michael A.; Fowler, Jeffrey M.; Judson, Patricia L.; Bell, Maria C.; De Geest, Koen; Spirtos, Nick M.; Potkul, Ronald K.; Leitao, Mario M.; Bakkum-Gamez, Jamie N.; Rossi, Emma C.; Lentz, Samuel S.; Burke, James J.; Van Le, Linda; Trimble, Cornelia L.

    2013-01-01

    Objective To determine which patients with near midline lesions may safely undergo unilateral groin dissection based on clinical exam and lymphoscintigraphy (LSG) results. Methods Patients participating in GOG-173 underwent sentinel lymph node (SLN) localization with blue dye, and radiocolloid with optional LSG before definitive inguinal-femoral lymphadenectomy (LND). This analysis interrogates the reliability of LSG alone relative to primary tumor location in those patients who had an interpretable LSG and at least one SLN identified. Primary tumor location was categorized as lateral (>2 cm from midline), midline, or lateral ambiguous (LA) if located within 2 cm., but not involving the midline. Results Two-hundred-thirty-four patients met eligibility criteria. Sixty-four had lateral lesions, and underwent unilateral LND. All patients with LA (N=65) and midline (N=105) tumors underwent bilateral LND. Bilateral drainage by LSG was identified in 14/64 (22%) patients with lateral tumors, 38/65 (58%) with LA tumors and in 73/105 (70%) with midline tumors. At mapping, no SLNs were found in contralateral groins among those patients with LA and midline tumors who had unilateral-only LSGs. However, in these patients groin metastases were found in 4/32 patients with midline tumors undergoing contralateral dissection; none were found in 27 patients with LA tumors. Conclusion The likelihood of detectable bilateral drainage using preoperative LSG decreases as a function of distance from midline. Patients with LA primaries and unilateral drainage on LSG may safely undergo unilateral SLN. PMID:23201592

  13. Unbalanced interchromosomal insertion diagnosed prenatally by FISH, with carrier mother, previously misdiagnosed as having a balanced reciprocal translocation

    SciTech Connect

    Yu, M.T.; Leiber, E.; Qazi, Q. [and others

    1994-09-01

    Insertion translocations are rare. A carrier with a balanced insertion translocation is most likely to be detected through offspring with an unbalanced translocation. We with to report a case where a correct diagnosis, made prenatally with FISH, corrected the initial misdiagnosis of the mother in another institute. PDL received an amniotic fluid sample from a 28 y.o. woman (G5P2Sab1TOP1) at 19 wks gestation. The indications were a reported balanced translocation, t(6;13), in the mother and a previous daughter with an unbalanced translocation. Chromosome analysis of the amniocytes showed a female karyotype with an abnormal chr. 13. Since the mother was diagnosed as having t(6;13)(q21;q34), the der(13) in the amniocytes was initially assumed to result from an adjacent segregation of the t(6;13). However, the banding patterns of this abnormal chr. 13 did not fit into the above defined translocation. With FISH and a chr. 13 painting probe, this der(13) was painted in the proximal and the distal thirds, but NOT in the middle region. This indicates that the middle section of the der(13) must have originated from 6q. The banding pattern is compatible with a direct insertion of 6q15 to 6q23.3 into 13q21.2. Thus, the fetus has partial trisomy 6q. After counseling, the mother elected to terminate the pregnancy but later changed her mind. An 8 lb 12 oz baby girl was born at 36 wks. (mother diabetic). Chromosome analysis of the newborn blood confirmed the dx. The mother was studied, using multicolor painting probes for chromosomes 13 and 6, a balanced direct insertion of 6q15 to 6q23.3 into chr. 13q21.2 was clearly shown. The previous affected daughter with a 13q+ is now 4 y.o. (a restudy is planned). She has microcephaly, severe developmental delay and other dysmorphic features. This case illustrates the advantage of using FISH to arrive at a definitive diagnosis of an insertion translocation.

  14. Misdiagnosed zoophile tinea faciei and tinea corporis effectively treated with isoconazole nitrate and diflucortolone valerate combination therapy.

    PubMed

    Czaika, Viktor A

    2013-05-01

    There have been few published reports on the human transmission of Trichophyton mentagrophytes, a zoophilic fungus frequently occurring in pets. Here we report on 2 girls, living with a pet dwarf rabbit, who presented with inflammatory skin lesions positive for T. mentagrophytes and subsequently diagnosed as zoophile tinea faciei and tinea corporis. The patients were successfully treated with systemic terbinafine and 2-week therapy with Travocort cream containing isoconazole nitrate 1% and diflucortolone valerate 0.1%. PMID:23574022

  15. Misdiagnosed Case of Bronchial Carcinoid Presenting with Refractory Dyspnoea and Wheeze: A Rare Case Report and Review of Literature

    PubMed Central

    Santra, Avradip; Dutta, Pravati; Pothal, Sudarsan; Manjhi, Rekha

    2013-01-01

    A 59-year-old male smoker presented with persistent wheezing and occasional coughing that had been ongoing for two years and had been unsuccessfully treated with an inhalational ?2 agonist, an anticholinergic and an inhalational steroid in the last year. On clinical examination, a left-sided wheeze was detected. The initial chest X-ray was normal. A computed tomography (CT) scan of thorax demonstrated a mass lesion in the left main bronchus. On subsequent bronchoscopy, an endobronchial polypoid mass was detected in the left main bronchus, completely occluding the bronchial lumen. A biopsy taken from the mass revealed features of bronchial carcinoid. Bronchial carcinoid can present uncommonly with wheezes, resulting in misdiagnosis as bronchial asthma or chronic obstructive pulmonary disease (COPD). If an asthma or COPD patient does not respond to conventional therapy, a CT scan and subsequent bronchoscopy is warranted. PMID:23966830

  16. Whipple’s disease: misdiagnosed as sarcoidosis with further tricuspid valve endocarditis and pulmonary embolism – a case report

    PubMed Central

    Berent, Robert; Auer, Johann; Lassnig, Elisabeth; von Duvillard, Serge P; Crouse, Stephen F; Tuppy, Herwig; Eber, Bernd

    2009-01-01

    GH Whipple described a 36-year-old physician in 1907 with gradual loss of weight and strength, stools consisting chiefly of neutral fat and fatty acids, indefinite abdominal signs and a peculiar multiple arthritis. The patient died of this progressive illness. Whipple called it intestinal lipodystrophy since he observed accumulation of large masses of neutral fats and fatty acids in the lymph spaces. It was renamed Whipple’s disease in 1949. An infectious aetiology was suspected as early as Whipple’s initial report. However, successful treatment with antibiotics was not reported until 1952, which resulted in dramatic clinical responses. The cause is now known to be Tropheryma whipplei. Light and electron microscopy of infected tissue identified a gram-positive, non-acid-fast, periodic acid-Schiff (PAS) positive bacillus with a characteristic trilamellar plasma membrane resembling that of gram-negative bacteria. Whipple’s disease is extremely rare. It is a systemic infectious disorder affecting mostly middle-aged white men. The clinical presentation is often non-specific, which may make its diagnosis difficult. The four cardinal clinical manifestations are arthralgias, weight loss, diarrhoea and abdominal pain. The frequently vague articular symptoms can precede the diagnosis of Whipple’s disease by an average of 6–8 years. Lymph nodes and other tissues may present diagnostic problems, since the changes in routinely stained sections may mimic those of sarcoidosis. The detection of PAS-positive histiocytes in the small intestine remains the mainstay of the diagnosis, although Whipple’s disease without gastrointestinal involvement is described. We illustrate a case in which, retrospectively, the clinical presentation would have been typical for Whipple’s disease. However, the clinical presentation and the histological examinations of lymph nodes, liver biopsies and ascites initially were misinterpreted as sarcoidosis with consecutive immunosuppressive therapy and progressive worsening of the patient’s health presenting at least as sepsis with endocarditis. PMID:21686811

  17. A composite neoplastic lesion of the vulva with mixed features of fibroadenoma and hidradenoma papilliferum combined with pseudoangiomatous stromal hyperplasia containing multinucleated giant cells.

    PubMed

    Konstantinova, Anastasia M; Kacerovska, Denisa; Michal, Michal; Kazakov, Dmitry V

    2014-10-01

    Anogenital mammary-like glands (AGMLG) are nowadays considered a normal component of the anogenital area. Lesions affecting AGMLG are similar to those seen in breast. We present a case of a complex neoplastic lesion of the AGMLG with mixed features of fibroadenoma and hidradenoma papilliferum combined with pseudoangiomatous stromal hyperplasia. Multinucleated cells were detected in the pseudoangiomatous stromal hyperplasia areas as seen in some patients with neurofibromatosis type 1. The neoplasm is similar to rare mammary composite neoplasms that feature simultaneously patterns of a fibroepithelial neoplasms and intraductal papilloma. PMID:23503319

  18. “Proximal-type” epithelioid sarcoma vs. malignant rhabdoid tumor of the vulva: A case report, review of the literature, and an argument for consolidation

    Microsoft Academic Search

    Peter A. Argenta; Sajeena Thomas; Justin C. Chura

    2007-01-01

    Background.Vulvar sarcomas, which comprise less than 2% of vulvar malignancies, are a heterogeneous group of tumors. Sub-categorization of these tumors makes treatment strategies difficult to evaluate. “Proximal” type epithelioid sarcoma (PES) and malignant rhabdoid tumor (MRT) describe a rare subset of vulvar malignancies which share histologic features and an aggressive clinical course.

  19. Cylindroma of the breast in a 72-year-old woman with fibrocystic disease first misdiagnosed as a malignant lesion in imaging studies

    PubMed Central

    Taghipour, Shokouh; Shiryazdi, Seyed Mostafa; Sharahjin, Naser Sefidrokh

    2013-01-01

    Cylindroma is a benign skin adnexal tumour with apocrine and trichoepitheliomatous differentiation that is rarely seen in the breast. Here, we report a case of cylindroma in the subareolar region of the left breast in a 72-year-old woman who presented with a palpable mass .Ultrasound and mammographic reports of the lesion were considered probably malignant. An ultrasound-guided core needle biopsy was performed and the patient underwent wide local excision with axillary lymph nodes biopsy. Immunohistochemistry and histopathological studies confirmed cylindroma with fibrocystic changes in uninvolved parenchyma. PMID:23761615

  20. Lung Infarction due to Pulmonary Vein Stenosis after Ablation Therapy for Atrial Fibrillation Misdiagnosed as Organizing Pneumonia: Sequential Changes on CT in Two Cases

    PubMed Central

    Kwon, Mi-ri; Cho, Jong Ho; Um, Sang-Won

    2015-01-01

    Pulmonary vein (PV) stenosis is a complication of ablation therapy for arrhythmias. We report two cases with chronic lung parenchymal abnormalities showing no improvement and waxing and waning features, which were initially diagnosed as nonspecific pneumonias, and finally confirmed as PV stenosis. When a patient presents for nonspecific respiratory symptoms without evidence of infection after ablation therapy and image findings show chronic and repetitive parenchymal abnormalities confined in localized portion, the possibility of PV stenosis should be considered.

  1. Non-lesions, Misdiagnoses, Missed Diagnoses, and Other Interpretive Challenges in Fish Histopathology Studies: A Guide for Investigators, Authors, Reviewers, and Readers

    EPA Science Inventory

    Differentiating salient histopathologic changes from normal anatomic features or tissue artifacts can be decidedly challenging, especially for the novice fish pathologist. As a consequence, findings of questionable accuracy may be reported inadvertently, and the potential negativ...

  2. Primary parapharyngeal and skull base synovial sarcoma in a 13-year-old boy with neurofibromatosis radiologically misdiagnosed as a benign lesion

    PubMed Central

    Taghipour Zahir, Shokouh; Sharahjin, Naser Sefidrokh; Dadgarnia, Mohammad Hossein

    2013-01-01

    Synovial sarcoma is a rare form of malignant tumour and accounting approximately for 8% of all soft tissue sarcomas. Head and neck synovial sarcomas are uncommon and parapharyngeal space involvement is extremely rare. We report a case of synovial sarcoma in the parapharyngeal space of a 13-year-old boy with a history of neurofibromatosis presented with odynophagia, ptosis and left submandibular mass. The lesion extended from retrostyloid parapharyngeal space to the skull base and foramen jugular superiorly. The first clinical and radiological impressions were carotid jugular related tumours such as schwannoma and paraganglioma. PMID:23737583

  3. Identification of three novel OA1 gene mutations identified in three families misdiagnosed with congenital nystagmus and carrier status determination by real-time quantitative PCR assay

    Microsoft Academic Search

    Valérie Faugère; Sylvie Tuffery-Giraud; Christian Hamel; Mireille Claustres

    2003-01-01

    BACKGROUND: X-linked ocular albinism type 1 (OA1) is caused by mutations in OA1 gene, which encodes a membrane glycoprotein localised to melanosomes. OA1 mainly affects pigment production in the eye, resulting in optic changes associated with albinism including hypopigmentation of the retina, nystagmus, strabismus, foveal hypoplasia, abnormal crossing of the optic fibers and reduced visual acuity. Affected Caucasian males usually

  4. Genital pyoderma gangrenosum: report of two cases and published work review of Japanese cases.

    PubMed

    Satoh, Masataka; Yamamoto, Toshiyuki

    2013-10-01

    Pyoderma gangrenosum is an ulcerative skin disorder showing characteristic non-infectious ulcers and affects the lower extremities in approximately 70% of cases. Pyoderma gangrenosum is commonly associated with systemic diseases such as inflammatory bowel disease, rheumatoid arthritis and hematological malignancies. Herein, we report two cases of Japanese patients diagnosed with genital pyoderma gangrenosum. Case 1 was a 74-year-old woman without associated systemic complications, whose skin lesion resembled a squamous cell carcinoma and was limited to the vulva. Case 2 is an 89-year-old man, who suffered from myelodysplastic syndrome and acute myeloid leukemia, and presented with penile and leg ulcers mimicking pressure sores. Both cases responded well to systemic steroids. We review 13 genital pyoderma gangrenosum cases (76.9% male; aged 30-89 years) from 1996 to 2012 in Japan, including 11 previously reported cases and the present study's two cases. Four of the 13 genital pyoderma gangrenosum cases had associated systemic diseases and their skin lesions spread to the extragenital areas. Eight of the remaining nine genitalia-localized pyoderma gangrenosum cases had no associated systemic diseases. In conclusion, genital pyoderma gangrenosum is rare and may be misdiagnosed. It should therefore be considered in cases of refractory genital ulcers. In addition, genitalia-localized pyoderma gangrenosum tends to be without systemic complications. PMID:24033392

  5. Cysteine Dioxygenase 1 Is a Tumor Suppressor Gene Silenced by Promoter Methylation in Multiple Human Cancers

    E-print Network

    2012-01-01

    different types of cancers (breast, kidney, rectum, colon,kidney, bladder, lung, breast, ovary, uterus, cervix and vulva cancer.Kidney Bladder Trachea Lung Breast Ovary Uterus Cervix Vulva Testis Prostate a Cancer

  6. Trichomoniasis

    MedlinePLUS

    ... an infected partner, either through penis-to-vagina intercourse or vulva-to-vulva contact. The parasite cannot ... Women may have these symptoms: Discomfort with intercourse ... Vaginal itching Vulvar itching or swelling of the labia Vaginal ...

  7. Intradermal spitz nevi: a rare subtype of spitz nevi analyzed in a clinicopathologic study of 74 cases.

    PubMed

    Plaza, Jose A; De Stefano, Danielle; Suster, Saul; Prieto, Victor G; Kacerovska, Denisa; Michal, Michal; Sangueza, Martin; Kazakov, Dmitry V

    2014-04-01

    Spitz nevi are acquired melanocytic lesions with a wide histomorphological spectrum; reliable distinction from spitzoid melanoma is often difficult. Misdiagnoses of benign spitzoid tumors as spitzoid melanomas and vice versa are attributable to a frequently disturbing morphology and inconsistent or poorly defined histological criteria for diagnosis. Many recognized histological variants of Spitz nevi have been described, including the intradermal Spitz. Histopathologic descriptions of intradermal Spitz nevi have been done in the past; however, large studies addressing their histological spectrum have been lacking. We have retrospectively assessed the morphological features in 74 cases of intradermal Spitz nevi, excluding tumors clearly defined as atypical Spitz nevi and Spitzoid melanomas, to further delineate their histological spectrum. The patients' ages ranged from 5 to 81 years (median: 27). Anatomic location included: the upper extremities (27 cases), followed by head and neck (22 cases), lower extremities (9 cases), back (8 cases), buttock (5 cases), chest (1 case), and vulva (1 case). In 1 case, the anatomic location of the lesion was not available. Different histological variants were observed including hyalinized, polypoid, desmoplastic, angiomatoid, and halo Spitz. Morphological features evaluated included symmetry (100%), cell type (epithelioid 42%, spindle 16%, mixed 42%), maturation (85%), pigmentation (26%), chronic inflammation (24%), and mitotic activity (38%). Mild atypia was seen in 36 cases (49%), moderate atypia was seen in 28 cases (38%), and severe atypia was seen in 10 cases (14%). Intradermal Spitz nevus is a distinctive type of Spitz nevus that sometimes can be difficult to define given the unusual features that these lesions can show; thus, strict application of well-defined histological criteria and awareness of their morphological spectrum will facilitate definitive diagnosis. PMID:24736667

  8. Multifocality and recurrence risk: a quantitative model of field cancerization

    E-print Network

    Foo, Jasmine

    and neck (oral cavity, oropharynx, and larynx), lung, vulva, esophagus, cervix, breast, skin, colon understood, recent molecular genetic studies suggest a carcinogenesis model in which clonal expansion

  9. Wnt and EGF pathways act together to induce C. elegans male hook development

    E-print Network

    Sternberg, Paul W.

    Comparative studies of vulva development between Caenorhabditis elegans and other nematode species have provided some insight into the evolution of patterning networks. However, molecular genetic details are available ...

  10. [Vulval dermatitis: localized condition--serious problem].

    PubMed

    Kozlovskaia, V V; Tikhonovskaia, I V

    2012-01-01

    An overview of the literature of the dermatitis of the vulva is presented. The etiology, epidemiology, clinical manifestations, diagnosis, pathological diagnosis, treatment, and prevention of contact, allergic-contact, atopic, and seborrheic dermatitis of the vulva are described in details. Lichen simplex chronicus is additionally described as complication of chronic itching dermatitis. PMID:23534270

  11. Oviposition Process of Solenopsis invicta (Hymenoptera: Formicidae) Queens

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The oviposition process of Solenopsis invicta is described as a succession of four events forming one egg-laying cycle. Each time an egg is laid, the vulva opens and the sting is fully extended. When the vulva closes, the egg is forced to the base of the sting, whereupon the sting is usually retract...

  12. Functional expression and characterization of a cytosolic copper\\/zinc-superoxide dismutase of Spirometra erinacei

    Microsoft Academic Search

    Ai-Hua Li; Byoung-Kuk Na; Sung-Kyu Ahn; Shin-Hyeong Cho; Jhang-Ho Pak; Yun-Kyu Park; Tong-Soo Kim

    2010-01-01

    Spirometra erinacei is a pseudophyllidean tapeworm which inhabits the intestines of cats and dogs. The infections are usually asymptomatic in\\u000a these animals, but the infection of the plerocercoid larvae of the parasite, spargana, cause sparganosis in other vertebrates,\\u000a including human. In this study, we identified a gene encoding the copper\\/zinc-superoxide dismutase of S. erinacei (SeCuZnSOD) and partially characterized the biochemical

  13. Circuits attenuating seizures under well-fed and food-deprived conditions in C. elegans male sex muscles 

    E-print Network

    Leboeuf, Brigitte L.

    2010-07-14

    or not at all, vulva penetration and thus successful mating will not occur. In this dissertation, I elucidate the circuits regulating sex-muscle excitability under standard conditions and describe how these pathways are augmented to further reduce excitability...

  14. Human Papillomaviruses; Epithelial Tropisms, and the Development of Neoplasia

    E-print Network

    Egawa, Nagayasu; Egawa, Kiyofumi; Griffin, Heather; Doorbar, John

    2015-01-01

    sometimes infect sites where full productive infection is either not 512 supported or supported only poorly. The different cancer risk at the penis, vagina and vulva, when 513 compared to the cervix or anus illustrates this well [129]. In addition...

  15. Vaginal itching and discharge - child

    MedlinePLUS

    Pruritus vulvae; Itching - vaginal area; Vulvar itching ... Common causes of vaginal itching and discharge in young girls include: Chemicals such as perfumes and dyes in detergents, fabric softeners, creams, ointments, ...

  16. ATP-binding cassette protein E is involved in gene transcription and translation in Caenorhabditis elegans

    E-print Network

    Baillie, David

    assays. ABCE promoters drove GFP expressions in hypoderm, pharynx, vulvae, head, and tail neurons at all of organelles like endoplasmic reticulum, peroxisome, and mitochondria [1,2]. A functional ABC transporter gen

  17. What's New in Vulvar Cancer Research and Treatment?

    MedlinePLUS

    ... the vulva. There are some promising new developments. Oncogenes and tumor suppressor genes Scientists are learning more about how certain genes called oncogenes and tumor suppressor genes control cell growth and ...

  18. Claude Chastagner 1 rue Ranchin

    E-print Network

    Boyer, Edmond

    knew a girl named Nikki [...] I met her in a hotel lobby she was masturbating with a magazine" (Prince', a famous, once secret painting by Courbet that represents the naked vulva of a reclining woman. So far

  19. Dealing with Sexual Problems

    MedlinePLUS

    ... the vulva (vulvectomy) Pelvic exenteration Sex and pelvic radiation therapy Sex and chemotherapy Sex and hormone therapy Surgery for breast cancer can affect sexuality, too Summary table of how ...

  20. Radical Hysterectomy

    MedlinePLUS

    ... the vulva (vulvectomy) Pelvic exenteration Sex and pelvic radiation therapy Sex and chemotherapy Sex and hormone therapy Surgery for breast cancer can affect sexuality, too Summary table of how ...

  1. Vulvar Care

    MedlinePLUS

    ... A make up remover that contains mineral oil, petroleum jelly, and paraffi n also can be used ( ... washcloth and put it against your vulva. Refrigerated petroleum jelly (Vaseline) and cold plain yogurt put on ...

  2. elife.elifesciences.org VijayRaghavan and Rath. eLife 2013;2:e00729. DOI: 10.7554/eLife.00729 1 of 3

    E-print Network

    , the fallopian tubes, which convey eggs from the ovaries to the uterus, decreases the incidence of ovarian cancer, before moving on to the uterus and finally being deposited from the vulva (Figure 1; Middleton et al

  3. Determining Pregnancy in Cattle 

    E-print Network

    Beverly, John R.; Sprott, L. R.; Carpenter, Bruce B.

    2008-12-16

    through a small opening (urethral orifice) on the floor of the vagina, eventually exit- ing the body through the vulva. Figure 2. Anatomy of the reproductive tract. CARUNCLES OVIDUCT CORPUS LUTEUM OVARY INFUNDIBULUM UTERUS FOLLICLE CERVIX VAGINA URETHRAL... ORIFICE VULVA CLITORIS 6 The cervix is a thick-walled structure attached to the vagina. It is comprised of connective tissue, which feels much like gristle. Because of the thick- ness and firm feel, the cervix is a good landmark for orientation while...

  4. Parasitic diseases of the central nervous system.

    PubMed

    Abdel Razek, Ahmed Abdel Khalek; Watcharakorn, Arvemas; Castillo, Mauricio

    2011-11-01

    This article reviews the characteristic imaging appearances of parasitic diseases of the central nervous system, including cysticercosis, toxoplasmosis, cystic echinococcosis, schistosomiasis, amebiasis, malariasis, sparganosis, paragonimiasis, and American and African trypanosomiases. Routine precontrast and postcontrast MR imaging helps in localization, characterization, delineation of extension, and follow-up of the parasitic lesions. Moreover, recently developed tools, such as diffusion, perfusion, and MR spectroscopy, help to differentiate parasitic diseases of the central nervous system from simulating lesions. Combining imaging findings with geographic prevalence, clinical history, and serologic tests is required for diagnosis of parasitic diseases of the central nervous system. PMID:22032501

  5. Giant Vulvar Epidermoid Cyst in an Adolescent Girl

    PubMed Central

    Karaman, Erbil; Çim, Numan; Akdemir, Zülküf; Elçi, Erkan; Akdeniz, Hüseyin

    2015-01-01

    Introduction. Vulvar cyst in adolescent girls is very uncommon. Epidermoid cyst can be seen in many sites including face, trunk, and extremities but its occurrence in vulva is uncommon. This is the first case of epidermoid cyst of vulva reported in an adolescent girl. Case. A 17-year-old, adolescent girl admitted to our gynecology outpatient clinic with a complaint of painful and palpable mass in her vulva. On examination, a giant mass located in left vulva and labia majora with 11?cm in diameter was seen. The magnetic resonance imaging (MRI) showed a well-defined cystic mass without contrast enhancement. The surgery was advised to the patient and the pathologic examination of mass revealed vulvar epidermoid cyst. Discussion. Vulvar cysts generally grow slowly and the main etiologies are vulvar trauma and surgical interventions including episiotomy and female circumcision in some culture. The exact treatment is total surgical excision and pathologic examination. MRI is an important imaging modality for detection of extension to deep perineal tissue and localization of mass in vulva especially in giant ones. Conclusion. Although vulvar mass in adolescents is rare, the epidermoid cyst with benign origin should be kept in mind. PMID:25949839

  6. Giant vulvar epidermoid cyst in an adolescent girl.

    PubMed

    Karaman, Erbil; Çim, Numan; Akdemir, Zülküf; Elçi, Erkan; Akdeniz, Hüseyin

    2015-01-01

    Introduction. Vulvar cyst in adolescent girls is very uncommon. Epidermoid cyst can be seen in many sites including face, trunk, and extremities but its occurrence in vulva is uncommon. This is the first case of epidermoid cyst of vulva reported in an adolescent girl. Case. A 17-year-old, adolescent girl admitted to our gynecology outpatient clinic with a complaint of painful and palpable mass in her vulva. On examination, a giant mass located in left vulva and labia majora with 11?cm in diameter was seen. The magnetic resonance imaging (MRI) showed a well-defined cystic mass without contrast enhancement. The surgery was advised to the patient and the pathologic examination of mass revealed vulvar epidermoid cyst. Discussion. Vulvar cysts generally grow slowly and the main etiologies are vulvar trauma and surgical interventions including episiotomy and female circumcision in some culture. The exact treatment is total surgical excision and pathologic examination. MRI is an important imaging modality for detection of extension to deep perineal tissue and localization of mass in vulva especially in giant ones. Conclusion. Although vulvar mass in adolescents is rare, the epidermoid cyst with benign origin should be kept in mind. PMID:25949839

  7. Spirometra (Pseudophyllidea, Diphyllobothriidae) Severely Infecting Wild-Caught Snakes from Food Markets in Guangzhou and Shenzhen, Guangdong, China: Implications for Public Health

    PubMed Central

    Gong, Shiping

    2014-01-01

    Sparganosis is a zoonotic disease caused by the spargana of Spirometra, and snake is one of the important intermediate hosts of spargana. In some areas of China, snake is regarded as popular delicious food, and such a food habit potentially increases the prevalence of human sparganosis. To understand the prevalence of Spirometra in snakes in food markets, we conducted a study in two representative cities (Guangzhou and Shenzhen), during January–August 2013. A total of 456 snakes of 13 species were examined and 251 individuals of 10 species were infected by Spirometra, accounting for 55.0% of the total samples. The worm burden per infected snake ranged from 1 to 213, and the prevalence in the 13 species was 0?96.2%. More than half (58.1%) of the spargana were located in muscular tissue, 25.6% in subcutaneous tissue, and 16.3% in coelomic cavity. The results indicated that Spirometra severely infected snakes in food markets in Guangzhou and Shenzhen, implying that eating snakes has great health risk and improper cooking methods may increase the risk of Spirometra infection in humans in China. Additional steps should be considered by the governments and public health agencies to prevent the risk of snake-associated Spirometra infections in humans. PMID:24558340

  8. Platynosomum fastosum-induced chronic intrahepatic cholangitis and Spirometra spp. infections in feral cats from Grand Cayman.

    PubMed

    Headley, S A; Gillen, M A; Sanches, A W D; Satti, M Z

    2012-06-01

    The occurrence of platynosomiasis and intestinal sparganosis is described in feral cats from Grand Cayman, Cayman Islands. Spirometra spp. was observed within the intestine of 18.18% (10/55) of cats; 1.18% (1/55) of cats demonstrated gross and histological manifestation of parasitism by Platynosomum fastosum, but 14.5% (8/55) of cats had the characteristic pathological manifestations of P. fastosum-induced intrahepatic cholangitis without the concomitant presence of the intraductal trematode. Combined parasitism (Spirometra spp. and P. fastosum) was observed in 9.09% (5/55) of feral cats. Significant pathological findings were only associated with the hepatic fluke, P. fastosum, and were grossly characterized by moderate hepatomegaly with enlarged and dilated bile ducts. Examples of cestodes with morphological features characteristic of Spirometra spp. were observed within the small intestine without any associated pathological lesion. The histopathological evaluation of liver fragments revealed chronic intrahepatic cholangitis with and without the associated intraductal trematode, and was characterized by marked periductal fibrosis, adenomatous proliferation of bile duct epithelium, dilation of intrahepatic bile ducts and portal accumulations of inflammatory cells. The occurrence of the cestode in feral cats coupled with factors that are unique to Grand Cayman makes this island the ideal location for sporadic cases of human sparganosis. PMID:21729387

  9. The emergence of mecC methicillin-resistant Staphylococcus aureus

    E-print Network

    Paterson, Gavin K.; Harrison, Ewan M.; Holmes, Mark A.

    2013-11-12

    The report of methicillin-resistant Staphylococcus aureus (MRSA) encoding a divergent mecA gene in 2011 was highly significant. This homologue, designated mecC, poses diagnostic problems with the potential to be misdiagnosed as methicillin...

  10. CADASIL

    MedlinePLUS

    ... arteries. CADASIL is characterized by migraine headaches and multiple strokes progressing to dementia. Other symptoms include cognitive ... available before 2000, many cases were misdiagnosed as multiple sclerosis, Alzheimer's disease, or other neurodegenerative diseases. Is ...

  11. Revised 15/04/2014 The Physiology of the Senses

    E-print Network

    Vilis, Tutis

    potentials in the 8th nerve. 3. Design a good cochlear implant. Provide an explanation for your design and family. Children who are hard of hearing are often misdiagnosed as cognitively impaired. The sound

  12. Quit Obsessing!

    ERIC Educational Resources Information Center

    Schlozman, Steven C.

    2002-01-01

    Asserts the obsessive-compulsive disorder is often misdiagnosed in children and adolescents; describes characteristics of obsessive-compulsive disorder; differentiates between normal and abnormal obsessions; suggests ways teachers can help students diagnosed with the disorder. (PKP)

  13. Calibration of sonographic gel probe covers for in-vivo mechanical testing

    E-print Network

    Charenkavanich, Panasaya

    2005-01-01

    Cervical insufficiency is a condition in pregnancy in which the cervix asymptomatically dilates in the absence of uterine contractions, resulting in a spontaneous preterm delivery. The condition is often misdiagnosed and ...

  14. SIDES: A Cooperative Tabletop Computer Game for Social Skills Development

    E-print Network

    Stanford University

    's Syndrome (AS) is a Pervasive Developmental Disorder and is considered an Autism Spectrum Disorder. Statistical data on the prevalence of AS is unclear, as many cases go undiagnosed or are misdiagnosed

  15. Revision of the Genus Nacobbus Thorne and Allen, 1944 (Nematoda: Tylenchoidea)

    PubMed Central

    Sher, S. A.

    1970-01-01

    All four species and one subspecies of the genus Nacobbus Thorne and Allen, 1944 were studied and measured from type specimens. Nacobbus batatiformis Thorne and Schuster, 1956; N. serendipiticus Franklin, 1959; and N. serendipiticus bolivianus Lordello, Zamith and Boock, 1961 are proposed as synonyms of N. aberrans (Thorne, 1935) Tborne and Allen, 1944. Nacobbus aberrans is distinguished from the type species N. dorsalis Thcrne and Allen, 1944 by the larger number of body annules between the vulva and anus; the lower position of the vulva in the young female; and the shape and number of eggs retained in the mature female. PMID:19322302

  16. Large Vulvar Lipoma in an Adolescent: A Case Report

    PubMed Central

    Chung, Seung Moon

    2008-01-01

    Lipomas are the most common benign tumors of soft tissues. However, conventional lipomas have been reported only rarely as presenting in the vulva. We present a case of vulvar lipoma in a 17-yr-old woman, possibly caused by chronic intermittent irritation. PMID:18756071

  17. Rare variants of malignant melanoma

    Microsoft Academic Search

    G. W. Milton; H. M. Shaw

    1992-01-01

    The personal experience with 5 rare types of malignant melanoma is reviewed to point out some of the practical problems in the diagnosis and management of these tumors. The rare forms discussed are conjunctival, nasal, oral, vulvar, and penile melanomas. All pigmented lesions in the oral cavity, but not the penis or vulva, should be prophylactically excised as lesions in

  18. Characterization of a New Species of Cyst Nematode Parasitizing Corn

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Examination of soil around unthrifty corn roots in northwestern Tennessee (Obion County) in 2006 revealed high population densities of juvenile nematodes and lemon-shaped cysts. This nematode resembles Cactodera spp. in possessing a circumfenestrate vulva but lacking bullae and an underbridge. These...

  19. Vaginal anus

    Microsoft Academic Search

    Fidel Ruiz-Moreno; Amable Gerdo-Ceballo; Gilberto Lozano-Saldivar

    1980-01-01

    A technique is described by which congenital ectopic anorectum with normal intestinal tissue opening into the vulva (“vaginal\\u000a anus”) was successfully corrected in two teen-age patients. The technique has several advantages: a new anal canal is formed\\u000a and the wounds heal promptly with little postoperative pain and reduced risk of postoperative anal stenosis.

  20. GENITAL HUMAN PAPILLOMA VIRUS (HPV) Dartmouth COOP

    E-print Network

    no signs of genital HPV, except with the few subtypes that cause condyloma acuminata (venereal warts). 6. HPV is the only cause of cervical cancer. HPV may also be linked to cancer of the anus, vulva, vagina. Currently there is no cure for HPV. However, a vaccine has just been approved by the FDA for use in girls

  1. Cell, Vol. 79, 1121-1124, December 30, 1994, Copyright 0 1994 by Cell Press Intimations of a Creature Minireview

    E-print Network

    Quake, Stephen R.

    it was his eye! yes, it was this! He had the eye of a vulture-" -Edgar Allan Poe, "The Tell-Tale Heart" Strikingly different animals have more in common than meets the eye. Animal architecture is guided by many is central body whether that happens to mean growing insect wings, a nematode vulva, or human ribs. Changes

  2. Approved by the UHS Patient Education Committee Page 1 of 1 Reviewed 12/20/11

    E-print Network

    Yener, Aylin

    Vaginal yeast infections are a very common problem in women. It is difficult to know the true percentage of the vulva is the most common symptom of a vaginal yeast infection. Women may also note pain with urination medications). To diagnose a vaginal yeast infection, a healthcare provider will take a medical history

  3. [Clinical approach in vulvar cancer surgery].

    PubMed

    Coulon, Pascale; Drouard, Isabelle; Leblanc, Eric; Narducci, Fabrice

    2011-11-01

    Vulva cancer is rare. It is mainly treated through surgery. Recurrent scarring complications can prolong the period of hospitalisation. To reduce scar dihiscence, the nursing team of the Oscar Lambret Centre in Lille treats scars by negative pressure as a preventative measure. It also integrates into its clinical approach the prevention of pain and malnutrition. PMID:22206212

  4. Morphological and molecular characterization of Pratylenchus lentis n. sp. (Nematoda: Pratylenchidae) from Sicily

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Pratylenchus lentis n. sp. parasitizing roots of lentil in Sicily, Italy, is described and illustrated. The new species is characterized by a high lip region with three annuli, stylet mean length of 16 micrometers with anteriorly flattened knobs, cylindrical body with a relatively anterior vulva, l...

  5. Development of specific monoclonal antibodies and a sensitive discriminatory immunoassay for the circulating tumor markers SCCA1 and SCCA2

    Microsoft Academic Search

    Sule Çataltepe; Charles Schick; Cliff J. Luke; Stephen C. O. Pak; Daniel Goldfarb; Philip Chen; Milenko J. Tanasiyevic; Marshall R. Posner; Gary A. Silverman

    2000-01-01

    The squamous cell carcinoma antigen (SCCA) serves as a serologic marker for advanced squamous cell carcinomas (SCC) of the uterine cervix, lung, esophagus, head and neck and vulva. Elevations in serum levels of SCCA following treatment for SCC correlate with tumor relapse or metastasis. Recent molecular studies show that SCCA is transcribed by two nearly identical genes (SCCA1 and SCCA2)

  6. Vulvar lichen sclerosus: clinical aspects and guidelines to management

    Microsoft Academic Search

    PETER J. LYNCH; LEONARDO MICHELETTI; FABRIZIO BOGLIATTO

    Lichen sclerosus is the second most frequently en- countered non-neoplastic disorder of the vulva. For this rea- son, gynecologists, dermatologists and primary care physicians should have a good understanding of the disease and its treat- ment. Most patients present with significant pruritus and, on examination, will be found to have white patches or plaques extending from the vestibule to the

  7. Genetic Control of Vulval Development in Caenorhabditis briggsae

    PubMed Central

    Sharanya, Devika; Thillainathan, Bavithra; Marri, Sujatha; Bojanala, Nagagireesh; Taylor, Jon; Flibotte, Stephane; Moerman, Donald G.; Waterston, Robert H.; Gupta, Bhagwati P.

    2012-01-01

    The nematode Caenorhabditis briggsae is an excellent model organism for the comparative analysis of gene function and developmental mechanisms. To study the evolutionary conservation and divergence of genetic pathways mediating vulva formation, we screened for mutations in C. briggsae that cause the egg-laying defective (Egl) phenotype. Here, we report the characterization of 13 genes, including three that are orthologs of Caenorhabditis elegans unc-84 (SUN domain), lin-39 (Dfd/Scr-related homeobox), and lin-11 (LIM homeobox). Based on the morphology and cell fate changes, the mutants were placed into four different categories. Class 1 animals have normal-looking vulva and vulva-uterine connections, indicating defects in other components of the egg-laying system. Class 2 animals frequently lack some or all of the vulval precursor cells (VPCs) due to defects in the migration of P-cell nuclei into the ventral hypodermal region. Class 3 animals show inappropriate fusion of VPCs to the hypodermal syncytium, leading to a reduced number of vulval progeny. Finally, class 4 animals exhibit abnormal vulval invagination and morphology. Interestingly, we did not find mutations that affect VPC induction and fates. Our work is the first study involving the characterization of genes in C. briggsae vulva formation, and it offers a basis for future investigations of these genes in C. elegans. PMID:23275885

  8. Successful Treatment with Lymphaticovenular Anastomosis for Secondary Skin Lesions of Chronic Lymphedema

    Microsoft Academic Search

    Sei-ichiro Motegi; Atsushi Tamura; Etsuko Okada; Yayoi Nagai; Osamu Ishikawa

    2007-01-01

    The treatment of severe lymphedema is a difficult challenge. We performed lymphaticovenular anastomosis on two patients with secondary skin lesions of chronic lymphedema; one patient exhibited acquired lymphangioma circumscriptum of the vulva and the other presented elephantiasis nostras verrucosa of the lower leg. Both patients obtained a remarkable improvement in skin lesions and also in the reduction of lymphedema of

  9. Genetic control of vulval development in Caenorhabditis briggsae.

    PubMed

    Sharanya, Devika; Thillainathan, Bavithra; Marri, Sujatha; Bojanala, Nagagireesh; Taylor, Jon; Flibotte, Stephane; Moerman, Donald G; Waterston, Robert H; Gupta, Bhagwati P

    2012-12-01

    The nematode Caenorhabditis briggsae is an excellent model organism for the comparative analysis of gene function and developmental mechanisms. To study the evolutionary conservation and divergence of genetic pathways mediating vulva formation, we screened for mutations in C. briggsae that cause the egg-laying defective (Egl) phenotype. Here, we report the characterization of 13 genes, including three that are orthologs of Caenorhabditis elegans unc-84 (SUN domain), lin-39 (Dfd/Scr-related homeobox), and lin-11 (LIM homeobox). Based on the morphology and cell fate changes, the mutants were placed into four different categories. Class 1 animals have normal-looking vulva and vulva-uterine connections, indicating defects in other components of the egg-laying system. Class 2 animals frequently lack some or all of the vulval precursor cells (VPCs) due to defects in the migration of P-cell nuclei into the ventral hypodermal region. Class 3 animals show inappropriate fusion of VPCs to the hypodermal syncytium, leading to a reduced number of vulval progeny. Finally, class 4 animals exhibit abnormal vulval invagination and morphology. Interestingly, we did not find mutations that affect VPC induction and fates. Our work is the first study involving the characterization of genes in C. briggsae vulva formation, and it offers a basis for future investigations of these genes in C. elegans. PMID:23275885

  10. Cutaneous warts and tumours in immunosuppressed patients.

    PubMed Central

    Leigh, I M; Glover, M T

    1995-01-01

    As increasing numbers of recipients of renal allografts survive long term, complications of prolonged immunosuppression have become apparent. Of particular concern are the high rates of non-melanoma skin cancer (NMSC) and carcinoma of the cervix, vulva and perineum. PMID:7769594

  11. Fournier’s Gangrene: A Monographic Urology Center Experience with Twenty Patients

    Microsoft Academic Search

    R. Martínez-Rodríguez; J. Ponce de León; J. Caparrós; H. Villavicencio

    2009-01-01

    Background: Fournier’s gangrene (FG) is a fatal synergistic infectious disease with necrotizing fasciitis of the perineum and abdominal wall along with the scrotum and penis in males and the vulva in females. The aim of this study was to share our experience in the management of this infectious disease. Methods: A retrospective chart review was performed in 20 patients with

  12. Linda M. Niccolai, PhD No one gets cervical cancer without first

    E-print Network

    of the anus, penis, vagina, vulva, and oropharynx. But there's a problem: by the end of 2012, the percentage that the vaccine can have a tremendous health impact, which speaks to the need to do a better job of getting kids. Niccolai immediately said, "Interventions. We need to get more kids vaccinated." That means targeting

  13. A hypothesis about the origin of sperm storage in the Eubrachyura, the effects of seminal receptacle structure on mating strategies and the evolution of crab diversity: How did a race to be first become a race to be last?

    Microsoft Academic Search

    Colin L. McLay; Laura S. López Greco

    2011-01-01

    The origins and evolution of sperm storage in Brachyura are enigmatic: sperm is either stored in seminal receptacles, accessible via the vulvae on the sixth thoracic sternite, or in spermathecae at the border between the seventh and eighth sternites. Crabs with spermathecae are collectively referred to as “podotremes” while crabs with seminal receptacles belong to the Eubrachyura. The position of

  14. Synchronous multifocal HPV-related neoplasm involving both the genital tract and the head-and-neck area: A case report of Fanconi anemia

    Microsoft Academic Search

    Tae-Jin Han; Chang-Hun Lee; Chong-Woo Yoo; Hye-Jin Shin; Hyun-Jin Park; Kwan Ho Cho; Joo-Yong Park; Sung-Won Choi; Joo-Young Kim

    2009-01-01

    We report the case of a 32-year-old woman who presented with multiple squamous cell neoplasms synchronously arising in the cervix, vulva, oral cavity and oropharynx. During the period when the patient was treated by radiotherapy, she developed severe radiation mucositis and pancytopenia. Immunofluorescence staining for foci of the monoubiquitinated form of FANCD2 revealed a complete absence of such foci in

  15. Epidemiology of Human Papillomavirus Infection in Men, Cancers other than Cervical and Benign Conditions

    Microsoft Academic Search

    Anna R. Giuliano; Guillermo Tortolero-Luna; Elena Ferrer; Ann N. Burchell; Silvia de Sanjose; Susanne Kruger Kjaer; Nubia Muñoz; Mark Schiffman; F. Xavier Bosch

    2008-01-01

    Human papillomavirus (HPV) infection is commonly found in the genital tract of men and women with or without any clinical lesion. The association of HPV DNA with several different ano-genital cancers other than cervical has been reported for the vulva, vagina, anus and penis. HPV DNA has also been identified in head and neck cancers in the oral cavity, the

  16. El estado del arte en las infecciones producidas por el virus del papiloma humano (VPH)

    Microsoft Academic Search

    R EINA; NUBIA M UÑOZ

    SUMMARY Anogenital human papillomavirus infection is the most frequent sexually transmitted disease. Around one hundred genotypes have been identified in humans, and 40 infect the genitalia and anal regions. Fifteen genotypes, classified as high- risk HPVs, are the necessary cause of cervical cancer and have been involved as carcinogenic agents for cancer of the vulva, vagina, anus, penis, and oropharyngeal

  17. INTRODUCTION A central issue in developmental biology is how discrete cells

    E-print Network

    Horvitz, H. Robert

    ; discussed in Li and Chalfie, 1990; Thomas et al., 1990). Eggs are stored in the mesodermal uterus, once formed, the vulva connects properly to the uterus. A signal from the uterine anchor cell (AC that attach the uterus to the lateral epidermis (seam) on each side of the animal, connected by a thin planar

  18. Purdue extensionPurdue extension AS-561-WAS-561-W

    E-print Network

    is the cervix. The cervix is the barrier between the vagina and the uterus. It serves to protect the more delicate and highly vascularized uterus from invasion by foreign uterine horns uterus cervix vagina vulva · Knowledge to Go objects, and is also a tight seal that keeps the uterus closed during pregnancy. The uterus

  19. A Bacterial Artificial Chromosome-Based Genetic Linkage Map of the Nematode Pristionchus pacificus

    Microsoft Academic Search

    Jagan Srinivasan; Waltraud Sinz; Christa Lanz; Alexandra Brand; Ramkumar Nandakumar; Gunter Raddatz; Hanh Witte; Heike Keller; Isabel Kipping; Taco Jesse; Jun Millare; Stephan C. Schuster; Ralf J. Sommer

    2002-01-01

    To understand the evolution of developmental processes, nonmodel organisms in the nematodes, insects, and vertebrates are compared with established model systems. Often, these comparisons suffer from the inability to apply sophisticated technologies to these nonmodel species. In the nematode Pristion- chus pacificus, cellular and genetic analyses are used to compare vulva development to that of Caenorhabditis elegans. However, substantial changes

  20. Vulvar Squamous Cell Carcinoma in Young Women: A Clinicopathologic Study of 21 Cases

    Microsoft Academic Search

    A. Al-Ghamdi; D. Freedman; D. Miller; C. Poh; M. Rosin; L. Zhang; C. B. Gilks

    2002-01-01

    Objectives. Invasive squamous cell carcinoma (ISCC) of the vulva occurs most often in older women and the clinical, pathological, and immunohistochemical features of vulvar ISCC in young women are poorly characterized. The aim of this study was to examine clinical and pathological features of ISCC presenting in women younger than 40 years of age.Methods. Patients younger than 40 years of

  1. Vulvar lichen sclerosus and squamous cell carcinoma: A cohort, case control, and investigational study with historical perspective; implications for chronic inflammation and sclerosis in the development of neoplasia

    Microsoft Academic Search

    J. Andrew Carlson; Robert Ambros; John Malfetano; Jeffery Ross; Richard Grabowski; Philina Lamb; Helen Figge; Martin C Mihm

    1998-01-01

    The histological changes of lichen sclerosus (LS) are frequently found in association with vulvar squamous cell carcinoma (SCC). The importance of chronic inflammation and scarring in oncogenesis is well recognized. Thirty-two patients with symptomatic vulvar LS and 60 with vulvar SCC were studied. Paraffin sections of vulvar LS, and three controls groups (acute scars, normal vulva, and vulvar lichen simplex

  2. Treatment for upper-limb and lower-limb lymphedema by professionals specializing in lymphedema care

    Microsoft Academic Search

    D. LANGBECKER; S. C. HAYES; B. NEWMAN; M. JANDA

    2008-01-01

    Up to 60% of patients with cancer of the vulva, and between 20 and 30% of patients with breast or abdominal cancers may develop lymphedema following treatment. The aims of this study were to assess health profes- sionals' knowledge about treatment, diagnostic procedures, advice and confidence in treatment of patients with either upper-limb (ULL) or lower-limb lymphoedema (LLL), and whether

  3. Effects of Feeding Barley Naturally Contaminated with Fusarium Mycotoxins on Growth Performance, Nutrient Digestibility, and Blood Chemistry of Gilts and Growth Recoveries by Feeding a Non-contaminated Diet.

    PubMed

    Kong, C; Shin, S Y; Park, C S; Kim, B G

    2015-05-01

    The objectives of this study were to investigate the effects of feeding barley naturally contaminated with Fusarium mycotoxins on growth performance, vulva swelling, and digestibility of dry matter, organic matter, and crude protein of gilts and the recovery of gilts fed normal diets immediately after the exposure to contaminated diets by measuring growth performance and vulva swelling. In Exp. 1, four diets were prepared to contain 0%, 15%, 30%, or 45% contaminated barley containing 25.7 mg/kg deoxynivalenol and 26.0 ?g/kg zearalenone. Sixteen gilts with an initial body weight (BW) of 33.3 kg (standard deviation = 3.0) were individually housed in a metabolism crate and assigned to 4 diets with 4 replicates in a randomized complete block design based on BW. During the 14-d feeding trial, individual BW and feed consumption were measured weekly and the vertical and horizontal lengths of vulva were measured every 3 d. From d 10, feces were collected by the maker-to-marker method for 4 d. Blood samples were collected on d 14. During the overall period, the average daily gain, average daily feed intake, and gain:feed of pigs linearly decreased (p<0.01) as the dietary concentration of contaminated barley increased. However, the digestibility of crude protein was linearly increased (p = 0.011) with the increasing amounts of contaminated barley. Increasing dietary Fusarium mycotoxin concentrations did not influence vulva size, blood characteristic as well as immunoglobulin level of pigs. In the Exp. 2, a corn-soybean meal-based diet was formulated as a recovery diet. Pigs were fed the recovery diet immediately after completion of the Exp. 1. During the 14-d of recovery period, the individual BW and feed consumption were measured weekly and the vertical and horizontal length of vulva were measured every 3 d from d 0. On d 7, the feed intake of pigs previously fed contaminated diets already reached that of pigs fed a diet with 0% contaminated barley and no significant difference in growth performance among treatments was observed during d 7 to 14 of the recovery period. In conclusion, increasing levels of mycotoxins in diets linearly decreased the growth performance of pigs, and these damages can be recovered in 7 d after the diet was replaced with a normal diet. The vulva size, blood characteristic, immune responses were not affected by increasing level of contaminated barley in the diets fed to pigs. PMID:25715687

  4. Chondroblastoma-like osteosarcoma: a case report and review.

    PubMed

    Aycan, Osman Emre; Vanel, Daniel; Righi, Alberto; Arikan, Yavuz; Manfrini, Marco

    2015-06-01

    Chondroblastoma-like osteosarcomas are extremely rare malignancies having varying clinical, radiological and histological features. Their rarity causes challenges in both diagnosis and clinical management. They are often misdiagnosed as benign lesions. Their accurate diagnosis is important because they require adequate treatment. Misdiagnosed lesions or undertreatment may result in recurrences. We report a case of chondroblastoma-like osteosarcoma arising in the left first metatarsal bone with tarsometatarsal joint involvement in a 10-year-old boy for whom surgery with an original technique was planned after a multidisciplinary diagnostic review. PMID:25492634

  5. Perioral dermatitis -- the role of nasal steroids.

    PubMed

    Peralta, Lígia; Morais, Paulo

    2012-06-01

    We present two patients with allergic rhinitis who developed perioral dermatitis (PD) after initiating intranasal steroid spray. Both patients had been previously misdiagnosed as having contact or seborrheic dermatitis, and therefore inappropriately and unsuccessfully treated with topical steroids. Physicians should be aware of this potential side effect of intranasal steroids to avoid incorrect therapeutic measures. In the setting of nasal steroids use, PD probably is an under-reported and commonly misdiagnosed condition that should be thought when a patient treated with nasal steroids present with small erythematous papules, papulovesicles, and papulopustules occurring against a background of redness, beginning in the nasolabial areas and spreading rapidly to the perioral zone. PMID:21995785

  6. Vaginal prolapse in a pregnant Maine coon cat: a case report.

    PubMed

    McKelvey, K A; Beachler, T M; Ferris, K K; Diaw, M; Vasgaard, J M; Bailey, C S

    2015-07-01

    Vaginal prolapse is a condition characterised by excessive accumulation of mucosal oedema and protrusion of hyperplastic tissue through the vulva. It has been reported in ruminants and canines, but has not been characterised in felines. This report describes the history, clinical signs and treatment of a pregnant Maine coon cat with a Type III vaginal prolapse diagnosed approximately 54 days after the first day of mating. Prior to queening, the prolapse was reduced and retained using a vulvar cruciate suture. Due to the risk of dystocia and recurrence, a caesarean section with ovariohysterectomy was performed. Postoperatively, a stay suture was maintained in the vulva for 2 weeks, resulting in permanent reduction of the vaginal prolapse. To the authors' knowledge, this case represents the first report of the successful management of vaginal prolapse in a pregnant cat. PMID:25515654

  7. Morphological Variation in Xiphinema spp. from New York Orchards

    PubMed Central

    Georgi, Laura L.

    1988-01-01

    Xiphinema specimens were collected from orchards in southeastern, northeastern, and western New York. Total length, distance of vulva from anterior end, spear length (odontostyle plus odontophore), body diameter at vulva, tail length, anal body diameter, and length and diameter of hyaline tail tip were measured on fixed, glycerol-infiltrated adult females. Most specimens were identified as X. americanum or X. rivesi, but one western New York population was identified as X. californicum (a new record for New York). Multivariate analyses indicated that, with one exception, western New York populations of both X. americanum and X. rivesi were smaller and slimmer than their eastern counterparts. Regional differences were generally larger than differences attributed to host species. PMID:19290184

  8. Expression pattern and first functional characterization of riok-1 in Caenorhabditis elegans.

    PubMed

    Weinberg, Florian; Schulze, Ekkehard; Fatouros, Chronis; Schmidt, Enrico; Baumeister, Ralf; Brummer, Tilman

    2014-07-01

    Rio kinases are atypical serine/threonine kinases that emerge as potential cooperation partners in Ras-driven tumors. In the current study, we performed an RNAi screen in Caenorhabditis elegans to identify suppressors of oncogenic Ras signaling. Aberrant Ras/Raf signaling in C. elegans leads to the formation of a multi-vulva (Muv) phenotype. We found that depletion of riok-1, the C. elegans orthologue of the mammalian RioK1, suppressed the Muv phenotype. By using a promoter GFP construct, we could show that riok-1 is expressed in neuronal cells, the somatic gonad, the vulva, the uterus and the spermatheca. Furthermore, we observed developmental defects in the gonad upon riok-1 knockdown in a wildtype background. Our data suggest that riok-1 is a modulator of the Ras signaling pathway, suggesting implications for novel interventions in the context of Ras-driven tumors. PMID:24929033

  9. Description of Rhabdias breviensis n. sp. (Rhabditoidea: Rhabdiasidae) in two Neotropical frog species.

    PubMed

    do Nascimento, Luciana de Cássia Silva; Gonçalves, Evonnildo Costa; Melo, Francisco Tiago de Vasconcelos; Giese, Elane Guerreiro; Furtado, Adriano Penha; dos Santos, Jeannie Nascimento

    2013-09-01

    Nematodes of the genus Rhabdias Stiles & Hassall, 1905 (Rhabditoidea: Rhabdiasidae) have a dioecious free-living stage and a hermaphroditic stage that parasitises the lungs of amphibians and reptiles. Approximately 94 species of Rhabdias have been described. Because the similar morphological characteristics such as the labial structures, the location of the vulva and the shape of the tail of Rhabdias spp. hinder their identification, molecular biology techniques and scanning electron microscopy have been employed to diagnose species of this genus. This study describes Rhabdias breviensis n. sp., parasitic in the lungs of two Neotropical frog species Leptodactylus petersii Steindachner and Leptodactylus macrosternum Miranda-Ribeiro. The description of this species integrates classical taxonomy, scanning electron microscopy and a molecular analysis of the mitochondrial COI gene. The new species differs from all other Rhabdias species parasitic in Neotropical hosts in certain morphometric parameters, the position of the vulva, the host group and the cephalic characters. PMID:23949651

  10. Systemic treatment of vulvar cancer.

    PubMed

    Mahner, Sven; Prieske, Katharina; Grimm, Donata; Trillsch, Fabian; Prieske, Stefan; von Amsberg, Gunhild; Petersen, Cordula; Mueller, Volkmar; Jaenicke, Fritz; Woelber, Linn

    2015-06-01

    Squamous cell carcinoma of the vulva is a rare disease, accounting for approximately 5% of cancers of the female genital tract. Standard therapy for early-stage vulvar cancer mainly comprises of surgery of the vulva and groins. In locally advanced or metastatic vulvar cancer, neoadjuvant or definitive chemoradiation is often considered as an alternative treatment option. Given its rarity, the level of evidence for different treatment modalities is poor and few clinical trials have been performed on this disease. Therefore indication criteria for systemic treatment in advanced stage vulvar cancer vary widely among countries and institutions. This review focuses on the different systemic treatment options for patients with locally advanced, recurrent or metastatic vulvar cancer, and highlights the need for an international multicenter approach to identify the most effective therapeutic options. PMID:25997120

  11. The small ubiquitin-like modifier (SUMO) is required for gonadal and uterine-vulval morphogenesis in Caenorhabditis elegans

    Microsoft Academic Search

    Limor Broday; Irina Kolotuev; Christine Didier; Anindita Bhoumik; Bhagwati P. Gupta; Paul W. Sternberg; Benjamin Podbilewicz; Ze' ev Ronai

    2004-01-01

    The small ubiquitin-like modifier (SUMO) modification alters the subcellular distribution and function of its substrates. Here we show the major role of SUMO during the development of the Caenorhabditis elegans reproductive system. smo-1 deletion mutants develop into sterile adults with abnormal somatic gonad, germ line, and vulva. SMO-1GFP reporter is highly expressed in the somatic reproductive system. smo-1 animals lack

  12. [Surprise in abrasion diagnostics].

    PubMed

    Kellner, U; Kellner, A; Cirkel, U

    2015-05-01

    Typical localizations of gynecological squamous cell carcinomas are the cervix, vulva and vagina and are therefore not uncommonly diagnosed in curettages. A differentiation from reactive hyperplastic alterations with a possible invasiveness in samples taken from the surface of the special type of well-differentiated verrucous squamous cell carcinoma can be difficult. This pitfall of such a tumor is presented in the case described here with corresponding diagnostic difficulties. PMID:25941098

  13. Total acquired vulval synechia: an unusual presentation.

    PubMed

    Kallam, Anji Reddy

    2015-04-01

    An unusual case of Acquired Total vulval synechia due to vulvar Lichen planus is reported in an 18-year-old girl, which is an extremely rare condition. It has a potential for producing extensive scarring and narrowing of introitus resulting in dyspareunia and rarely carcinoma of vulva. Successful surgical management of total vulvar synechiae in patient suffering from Lichen Planus is being reported. PMID:26023590

  14. Total Acquired Vulval Synechia: An Unusual Presentation

    PubMed Central

    2015-01-01

    An unusual case of Acquired Total vulval synechia due to vulvar Lichen planus is reported in an 18-year-old girl, which is an extremely rare condition. It has a potential for producing extensive scarring and narrowing of introitus resulting in dyspareunia and rarely carcinoma of vulva. Successful surgical management of total vulvar synechiae in patient suffering from Lichen Planus is being reported. PMID:26023590

  15. Ovarian carcinoma producing parathyroid hormone-related protein causing hypercalcemia and metastatic calcification detected on 18F-FDG PET-CT

    PubMed Central

    Agarwal, Krishan Kant; Karunanithi, Sellam; Jain, Sachin; Kumar, Rakesh

    2013-01-01

    Hypercalcemia is associated with gynecologic malignant diseases, and cases involving various organs such as the uterus, ovaries, vulva, and vagina. This may be due to elevated levels of parathyroid hormone-related peptide (PTHrP). We describe here two cases of ovarian carcinoma simultaneously producing PTHrP that caused hypercalcemia and metastatic calcification detected on 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography (PET-CT). PMID:24379537

  16. Synchronous multifocal HPV-related neoplasm involving both the genital tract and the head-and-neck area: a case report of Fanconi anemia.

    PubMed

    Han, Tae-Jin; Lee, Chang-Hun; Yoo, Chong-Woo; Shin, Hye-Jin; Park, Hyun-Jin; Cho, Kwan Ho; Park, Joo-Yong; Choi, Sung-Won; Kim, Joo-Young

    2009-07-01

    We report the case of a 32-year-old woman who presented with multiple squamous cell neoplasms synchronously arising in the cervix, vulva, oral cavity and oropharynx. During the period when the patient was treated by radiotherapy, she developed severe radiation mucositis and pancytopenia. Immunofluorescence staining for foci of the monoubiquitinated form of FANCD2 revealed a complete absence of such foci in all cancer tissues that were examined. PMID:19368986

  17. LET23 Receptor Localization by the Cell Junction Protein LIN7 during C. elegans Vulval Induction

    Microsoft Academic Search

    Jeffrey S Simske; Susan M Kaech; Stacey A Harp; Stuart K Kim

    1996-01-01

    In C. elegans, the anchor cell signal induces Pn.p cells to form the vulva by activating a conserved receptor tyrosine kinase pathway. lin-2 and lin-7 mutants exhibit a vulvaless phenotype similar to the phenotype observed when this signaling pathway is defective. We have found that LIN-7 is a cell junction–associated protein that binds to the LET-23 receptor tyrosine kinase. LET-23

  18. Caenorhabditis elegans cog-1 Locus Encodes GTX\\/Nkx6.1 Homeodomain Proteins and Regulates Multiple Aspects of Reproductive System Development

    Microsoft Academic Search

    Robert E. Palmer; Takao Inoue; David R. Sherwood; Lily I. Jiang; Paul W. Sternberg

    2002-01-01

    The development of the reproductive system in Caenorhabditis elegans is a well-established model system for patterning and organogenesis. We report the characterization of the cog-1 gene, mutations in which cause novel phenotypes in late patterning in vulval lineages, establishment of the vulva–uterine connection, development and function of the spermathecal–uterine junction, and the development of vas deferens–proctodeal connection in the male.

  19. Protein kinase VRK-1 regulates cell invasion and EGL-17/FGF signaling in Caenorhabditis elegans

    PubMed Central

    Klerkx, Elke P.F.; Alarcón, Pilar; Waters, Katherine; Reinke, Valerie; Sternberg, Paul W.; Askjaer, Peter

    2012-01-01

    The Vaccinia-Related Kinases (VRKs) are highly conserved throughout the animal kingdom and phosphorylate several chromatin proteins and transcription factors. In early Caenorhabditis elegans embryos, VRK-1 is required for proper nuclear envelope formation. In this work we present the first investigation of the developmental role of VRKs by means of a novel C. elegans vrk-1 mutant allele. We found that VRK-1 is essential in hermaphrodites for formation of the vulva, uterus, utse, and for development and maintenance of the somatic gonad and thus the germ line. VRK-1 regulates anchor cell polarity and the timing of anchor cell invasion through the basement membranes separating vulval and somatic gonadal cells during the L3 larval stage. VRK-1 is also required for proper specification and proliferation of uterine cells and sex myoblasts. Expression of the Fibroblast Growth Factor-like protein EGL-17 and its receptor EGL-15 is reduced in vrk-1 mutants, suggesting that VRK-1 might act at least partially through activation of FGF signaling. Expression of a translational VRK-1::GFP fusion protein in the ventral nerve cord and vulva precursor cells restores vulva and uterus formation, suggesting both cell autonomous and non-autonomous roles of VRK-1. PMID:19679119

  20. Comparative vaginal cytology of the estrous cycle of black-footed ferrets (Mustela nigripes), Siberian polecats (M. eversmanni), and domestic ferrets (M. putorius furo).

    PubMed

    Williams, E S; Thorne, E T; Kwiatkowski, D R; Lutz, K; Anderson, S L

    1992-01-01

    Vaginal cytology and vulva size were used to characterize the reproductive cycle of female black-footed ferrets (Mustela nigripes), Siberian polecats (M. eversmanni), and domestic ferrets (M. putorius furo). Emphasis was on black-footed ferrets because of the need to breed these critically endangered animals and on Siberian polecats because of the close taxonomic relationship to black-footed ferrets. Vaginal cytology of the 3 species of ferret is similar. Proestrus was characterized by an increasing percentage of superficial epithelial cells and enlargement of the vulva. During estrus, superficial cells were usually greater than or equal to 90% of epithelial cells in the vaginal lavage and after several days were fully keratinized. Neutrophils were more common during all stages of the estrous cycle in domestic ferrets than they were in the other species. Following copulation, percentage of superficial calls in the vagina declined and vulva swelling subsided. Large cells, probably of uterine symplasma origin, were observed in vaginal lavages following whelping or pseudopregnancy. Vaginal cytology is extremely useful in the reproductive management of black-footed ferrets and Siberian polecats. Knowledge of normal vaginal cytology could be applied to the diagnosis of female reproductive abnormalities in all 3 species. PMID:1554767

  1. Program Suggestions for the Provision of Special Education Services to Limited English Proficient Students in Michigan Schools.

    ERIC Educational Resources Information Center

    Michigan State Board of Education, Lansing. Special Education Services.

    This document outlines processes necessary for the identification of and the educational planning for limited English proficient students who may be eligible for special education programs in Michigan. The importance of avoiding inappropriate referrals and misdiagnoses due to misinterpretation of cultural and linguistic diversity is stressed. The…

  2. At-Risk Youngsters: Methods That Work.

    ERIC Educational Resources Information Center

    Obiakor, Festus E.

    This paper examines problems faced by youngsters at risk of failure in school, and discusses methods for helping them succeed in educational programs. At-risk youngsters confront many problems in school and in mainstream society, and are frequently misidentified, misdiagnosed, and improperly instructed. Problems faced by at-risk youngsters…

  3. Congenital vein valve aplasia

    Microsoft Academic Search

    Gunnar Plate; Lars Brudin; Bo Eklöf; Ragnar Jensen; Per Ohlin

    1986-01-01

    Congenital vein valve aplasia is often misdiagnosed and its symptoms misinterpreted as being caused by previous deep venous thrombosis. The present article reviews the literature providing data on etiology, symptomatology, and phlebographic appearance in congenital vein valve aplasia. A personal experience with 10 cases focuses on the clinico-physiological results with compression therapy and surgical treatment of superficial venous insufficiency. Compressive

  4. Isolated Hepatic Tuberculosis Presenting as Cystic-Like and Tumour-Like Mass Lesions

    Microsoft Academic Search

    Cem Kaan Parsak; Ismail Hanta; Ahmet Aslan; Omer Alabaz

    2008-01-01

    Hepatic tuberculosis is a rare manifestation of extra-pulmonary tuberculosis. Hepatic tuberculous lesions are especially mimicking tumour-like mass or cystic lesions in the liver and so can be misdiagnosed with several diseases. Histopathological examination of the specimen is essential in the diagnosis for hepatic tuberculosis. In this report, two cases with hepatic tuberculosis having cystic solid mass and abscess liver lesions

  5. Biliary cystadenoma

    PubMed Central

    Bartolome, Miguel A Hernandez; Ruiz, Sagrario Fuerte; Romero, Israel Manzanedo; Lojo, Beatriz Ramos; Prieto, Ignacio Rodriguez; Alvira, Luis Gimenez; Carreño, Rosario Granados; Esteban, Manuel Limones

    2009-01-01

    The diagnosis of cystadenoma is rare, even more so when located in the extrahepatic bile duct. Unspecific clinical signs may lead this pathology to be misdiagnosed. The need for pathological anatomy in order to distinguish cystadenomas from simple biliary cysts is crucial. The most usual treatment nowadays is resection of the bile duct, together with cholecystectomy and Roux-en-Y reconstruction. PMID:19630118

  6. Comparison of Knowledge of Obsessive-Compulsive Behavior between Counseling Students and School Administration Students.

    ERIC Educational Resources Information Center

    Foster, Sandy

    Obsessive-compulsive adolescence behavior in the classroom environment can be disruptive, affecting the teacher and other students. Certain personality traits of the obsessive-compulsive are obvious, while other symptoms are frequently misdiagnosed. As school staff are often the first step in the primary diagnosis process, the purpose of this…

  7. Mis-Diagnosis and Dual Diagnosis of Gifted Children: Gifted and LD, ADHD, OCD, Oppositional Defiant Disorder.

    ERIC Educational Resources Information Center

    Webb, James T.

    Many gifted and talented children are often misdiagnosed by psychologists and other health professionals as having Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Disorder (OD), Obsessive Compulsive Disorder (OCD), or another of the mood disorders. The misdiagnosis can stem from mistaken assumptions being made about the social and…

  8. Autism and mental health: your guide to today's mental health issues.

    PubMed

    Gould, Judith

    Autism is not a mental health disorder, but it sometimes is misdiagnosed as one--and can bring its own mental health issues. Dr Judith Gould explains how a mental health problem may mask an undiagnosed autistic spectrum disorder. PMID:20073108

  9. The Effect of Screening Versus Nonscreening on Treatment Authorization in a Managed Care Setting

    Microsoft Academic Search

    Rodney C. Howard; Chas A. Bassos

    2000-01-01

    Many psychologists believe that screening evaluations required for treatment authorization are merely mechanisms to restrict needed patient care. Managers of behavioral health organizations, in contrast, fear that providers will misdiagnose patients to ensure reimbursement for unneeded services if not monitored. This study compared the managed behavioral health organization screening evaluation with direct therapist referral in terms of treatment eligibility determination.

  10. A misdiagnosis of clonorchiasis as gallstone, leading to an unnecessary cholecystectomy: a case report.

    PubMed

    Sun, Qingsong; Liu, Xiaolei; Hao, Yuhua; Li, YuXiang; Bai, Xue; Wang, Feng; Liu, Mingyuan

    2014-11-01

    This case report describes an unusual presentation of Clonorchissinensis infection. In this rare case, a clonorchiasis infection that had been latent for decades was misdiagnosed as acute calculous cholecystitis.Exploratory surgery and a cholecystectomy were performed. Therefore,in the course of diagnosis of hepatic and gall diseases, we cannot neglect parasite infections such as clonorchiasis. PMID:24881515

  11. The Emergence of Two Multiple Personalities in a Group: A Description and Assessment.

    ERIC Educational Resources Information Center

    Mason, Linda A.

    1987-01-01

    Despite an appropriate screening process, the potential for a misdiagnosed multiple personality to be included in a group is much higher than most therapists realize. Describes one long-term group's experience with the emergence of two multiple personalities. Explores critera for assessing whether such a person should remain in the group.…

  12. Sentence Repetition as a Measure of Morphosyntax in Monolingual and Bilingual Children

    ERIC Educational Resources Information Center

    Komeili, Mariam; Marshall, Chloe R.

    2013-01-01

    Bilingual children are frequently misdiagnosed as having Specific Language Impairment (SLI). Misdiagnosis may be minimized by tests with high degrees of sensitivity and specificity. The current study used a new test, the School-Age Sentence Imitation Test-English 32 (SASIT-E32), to investigate sentence repetition in monolingual and bilingual…

  13. Corticosteroids and liver amoebiasis

    Microsoft Academic Search

    P C Stuiver; T J Goud

    1978-01-01

    Patients with amoebiasis who receive steroid treatment may suffer adverse affects including acute amoebic dysentery and exacerbation of the amoebiasis. In some cases the presenting symptoms are initially misdiagnosed and steroids prescribed, which provokes fulminating progression of hepatic amoebiasis. Repeated stool examinations often yield negative results. Any patient being considered for treatment with corticosteroids who has lived in the tropics

  14. Appendectomy due to lead poisoning: a case-report

    Microsoft Academic Search

    S Mohammadi; AH Mehrparvar; M Aghilinejad

    2008-01-01

    BACKGROUND: Lead poisoning is a common occupational health hazard in developing countries and many misdiagnoses and malpractices may occur due to unawareness of lead poisoning symptoms. CASE PRESENTATION: We report a case of occupational lead poisoning in an adult battery worker with abdominal colic who initially underwent appendectomy with removal of normal appendix. Later on he was diagnosed with lead

  15. The man who got too close to his cows

    Microsoft Academic Search

    Shane Silver; Donald C. Vinh; John M. Embil

    2008-01-01

    Trichophyton verrucosum is one of the more common chronic zoophilic dermatophytes. Its presentation is diverse, including aggressive inflammatory skin lesions, and it can be accompanied by constitutional symptoms, such as fever and lymphadenopathy. As such, it may be misdiagnosed as bacterial cellulitis and undergo multiple antibiotic courses unsuccessfully, without consideration of a fungal skin infection. We present a cattle farmer

  16. Child Abuse Syndrome: The Cases We Miss

    Microsoft Academic Search

    Graham Jackson

    1972-01-01

    One hundred cases of physical injury to children are reviewed. Eighteen cases are shown to be misdiagnosed cases of child abuse. It is suggested that all hospitals review their records of childhood trauma in the light of these findings. All children under 4 years of age with trauma of non-obvious aetiology should be referred to the paediatrician.

  17. Erroneous diagnosis of chronic urinary retention in three women with pelvic cysts.

    PubMed

    Dunn, I B; Palmer, M

    2000-12-01

    Three cases are presented where pelvic masses were originally misdiagnosed as cases of chronic urinary retention. In all cases the erroneous diagnosis was made at outpatient assessment, where postmicturition ultrasound scan measurement of residual urine volume had been performed. This investigation, while a useful tool, must be viewed in the context of other clinical findings. PMID:11195904

  18. Advanced Clinical Interpretation of the WAIS-IV and WMS-IV: Prevalence of Low Scores Varies by Level of Intelligence and Years of Education

    ERIC Educational Resources Information Center

    Brooks, Brian L.; Holdnack, James A.; Iverson, Grant L.

    2011-01-01

    Clinicians can use the base rates of low scores in healthy people to reduce the likelihood of misdiagnosing cognitive impairment. In the present study, base rates were developed for the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) and Wechsler Memory Scale-Fourth Edition (WMS-IV) using 900 healthy adults and validated on 28 patients…

  19. Identifying Functional Neuroimaging Biomarkers of Bipolar Disorder: Toward DSM-V

    Microsoft Academic Search

    Mary L. Phillips; Eduard Vieta

    2007-01-01

    Bipolar disorder is one of the most debilitating and com- mon illnesses worldwide. Individuals with bipolar disorder frequently present to clinical services when depressed but are often misdiagnosed with unipolar depression, leading to inadequate treatment and poor outcome. Increased ac- curacy in diagnosing bipolar disorder, especially during depression, is therefore a key long-term goal to improve the mental health of

  20. Dissociative Disorders in Children: Behavioral Profiles and Problems.

    ERIC Educational Resources Information Center

    Putnam, Frank W.

    1993-01-01

    Clinical research has established a connection between childhood trauma and the development of dissociative disorders in adults. Pathological dissociation produces a range of symptoms and behaviors such as amnesias, rapid shifts in mood and behavior, and auditory and visual hallucinations. Many of these symptoms are misdiagnosed as attention,…

  1. High-Performing Families: Causes, Consequences, and Clinical Solutions. The Family Psychology and Counseling Series.

    ERIC Educational Resources Information Center

    Robinson, Bryan E., Ed.; Chase, Nancy D., Ed.

    This book explores the dilemma of the increasing obsession with work and the resulting imbalances between career and family life. Through theoretical frameworks and case examples it discusses the negative consequences of the societal phenomena of over-work and over-dedication to careers, which have been misdiagnosed or ignored by mental health…

  2. Living with the Active Alert Child: Groundbreaking Strategies for Parents. Third Edition.

    ERIC Educational Resources Information Center

    Budd, Linda S.

    Bright, controlling, fearful, and highly energetic, active alert children are frequently misdiagnosed as hyperactive or learning disabled. This book offers guidance for the special challenge of parenting the active alert infant, child, and adolescent. Part 1 of the book profiles the active alert child and examines 11 traits that characterize…

  3. [A woman with hyperkeratotic papules on arms and legs].

    PubMed

    van Winden, M E C; Chandeck, C; Martens, H

    2015-01-01

    A 50-year old woman with hyperkeratotic verrucous papules and plaques visited the outpatient clinic of Dermatology. Histopathology showed hyperplasia of verrucous epithelia, orthokeratosis and an infiltrate, leading to the diagnosis 'verrucous (hypertrophic) lichen planus'. This skin condition is often misdiagnosed as psoriasis. Squamous cell carcinoma can develop within skin lesions. PMID:26058761

  4. Gossypiboma as a rare cause of abdominal mass.

    PubMed

    Yildirim, Afra; Imamo?lu, Hakan; Erzurumda?, Asl?; Do?an, Serap

    2014-01-01

    Gossypiboma is a reaction to a foreign body/object left accidentally inside a patient as a consequence of surgery. This phenomenon may be overlooked due to its rarity or under-reported due to possible repercussions. We report an intra-abdominal gossypiboma that was misdiagnosed on ultrasound, and discuss its radiological findings. PMID:25414212

  5. A Preliminary Report on the English Phonology of Typically Developing English-Mandarin Bilingual Preschool Singaporean Children

    ERIC Educational Resources Information Center

    En, Lydea Gn Wei; Brebner, Chris; McCormack, Paul

    2014-01-01

    Background: There are no published data on typical phonological development for Singaporean children. There is therefore the risk that children's speech in Singapore may be misdiagnosed or that clinicians may set goals erroneously. Aims: This paper reports a preliminary study on the English phonology of typically developing 4;0-4;5-year-old…

  6. Neosporosis in animals-the last five years

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Neospora caninum is a protozoan parasite of animals. Until 1988, it was misdiagnosed as Toxoplasma gondii. Since its first recognition in 1984 in dogs and the description of a new genus and species Neospora caninum in 1988, neosporosis has emerged as a serious disease of cattle and dogs worldwide. ...

  7. Lipedema, a frequently unrecognized problem.

    PubMed

    Fonder, Margaret A; Loveless, James W; Lazarus, Gerald S

    2007-08-01

    Lipedema is characterized by symmetric lower extremity enlargement secondary to the deposition of fat. Lipedema is not rare, but it is commonly misdiagnosed as lymphedema. We describe a 20-year-old woman with massive lower extremity enlargement that did not respond to compression therapy. Magnetic resonance imaging of the lower extremities helped to confirm the diagnosis. PMID:17637360

  8. Reduction of Skin Stretch Induced Motion Artifacts in Electrocardiogram Monitoring Using Adaptive Filtering

    Microsoft Academic Search

    Yan Liu; Michael G. Pecht

    2006-01-01

    The effectiveness of electrocardiogram (ECG) monitors can be significantly impaired by motion artifacts which can cause misdiagnoses, lead to inappropriate treatment decisions, and trigger false alarms. Skin stretch associated with patient motion is a significant source of motion artifacts in current ECG monitoring. In this study, motion artifacts are adaptively filtered by using skin strain as the reference variable. Skin

  9. Kirit C. Shah, M.D. v. Stan Harris and Nancy Harris. "Construction of Legal Arguments, Statutes of Limitations, and Medical Malpractice." Lesson Plans for Secondary Teachers on How Lawyers Prepare Their Arguments. Courts in the Classroom: Curriculum Concepts and Other Information on Indiana's Courts for the K-12 Educator.

    ERIC Educational Resources Information Center

    Osborn, Elizabeth

    Stan and Nancy Harris filed a complaint against Kirit C. Shah, M.D., for misdiagnosing Mr. Harris's illness, charging Dr. Shah with negligence and asking for damages. A medical malpractice action in Indiana is governed by a two year statute of limitations. Because the Harrises failed to bring their action against Dr. Shah within this two year…

  10. Oral and maxillofacial surgery in patients with chronic orofacial pain

    Microsoft Academic Search

    Howard A. Israel; John Desmond Ward; Brenda Horrell; Steven J. Scrivani

    2003-01-01

    Purpose: In this investigation, we evaluated a population of patients with chronic orofacial pain who sought treatment at a pain center in an academic institution. These patients were evaluated with respect to 1) the frequency and types of previous oral and maxillofacial surgery procedures, 2) the frequency of previous significant misdiagnoses, and 3) the number of patients who subsequently required

  11. A young man with altered mental status and new-onset seizures.

    PubMed

    Cassa, Richard S; Rosengart, Axel J

    2013-10-01

    Signs and symptoms of a subacute, progressive, imaging-negative encephalopathy can be misdiagnosed as a neuropsychiatric or progressive neurodegenerative disorder. However, encephalopathies often can be reversed if the autoimmune component is recognized early through a careful history and diagnostic testing, including cerebrospinal fluid analysis for antibodies. PMID:24201920

  12. Rare adipose disorders (RADs) masquerading as obesity

    Microsoft Academic Search

    Karen L Herbst

    2012-01-01

    Rare adipose disorders (RADs) including multiple symmetric lipomatosis (MSL), lipedema and Dercum's disease (DD) may be misdiagnosed as obesity. Lifestyle changes, such as reduced caloric intake and increased physical activity are standard care for obesity. Although lifestyle changes and bariatric surgery work effectively for the obesity component of RADs, these treatments do not routinely reduce the abnormal subcutaneous adipose tissue

  13. Solitary fibrous tumor (SFT) of the pelvis

    Microsoft Academic Search

    Shiu Yan J. Wat; Monalisa Sur; Kavita Dhamanaskar

    2008-01-01

    Solitary fibrous tumors (SFTs) are well recognized in the pleura, but their occurrence at other sites has only become appreciated in recent years, as a consequence of which extrapleural examples often go unrecognized and misdiagnosed. Because of their rarity, overall experience concerning this tumor has not been significant and reports detailing radiological findings are few. We herein report an unusual

  14. A 60 year old Ethiopian farmer diagnosed with tick paralysis at Adera Medical Center.

    PubMed

    Bane, Abate

    2014-07-01

    A 60 year old farmer from west Shewa in Ethiopia presented on February 13 2014, with right arm flaccid monoplegia after bitten by a tick stuck to his right arm pit. The case was initially misdiagnosed as cellulitis. To our knowledge, tick paralysis has not been reported from Ethiopia. We report the case presentation with literature review. PMID:25812288

  15. Development of an Online Resource to Support General Education Elementary School Teachers in a Response to Intervention Model for Struggling Readers

    ERIC Educational Resources Information Center

    Lopez, Jennifer L.

    2010-01-01

    The number of students who are being identified as having a learning disability is rising at an alarming rate, creating concerns regarding misdiagnoses and overrepresentation of minority groups in special education. Response to Intervention (RtI) has emerged as a scientifically validated approach to delivering quality interventions early in a…

  16. Aberrant expression of epithelial and neuroendocrine markers in alveolar rhabdomyosarcoma: a potentially serious diagnostic pitfall

    Microsoft Academic Search

    Armita Bahrami; Allen M Gown; Geoffrey S Baird; M John Hicks; Andrew L Folpe

    2008-01-01

    Alveolar rhabdomyosarcoma may be extremely difficult to distinguish from other primitive round cell neoplasms without ancillary immunohistochemistry and\\/or genetic study. Particularly in adults and in the head and neck locations, the differential diagnosis of alveolar rhabdomyosarcoma includes small cell carcinoma and neuroepithelial tumors, such as esthesioneuroblastoma. We have recently seen cases of genetically confirmed alveolar rhabdomyosarcoma, which were misdiagnosed owing

  17. Filaroides osleri ( Oslerus osleri): Two case reports and a review of canid infections in North America

    Microsoft Academic Search

    Chaoqun Yao; Donal O’Toole; Mike Driscoll; Warner McFarland; Jonathan Fox; Todd Cornish; William Jolley

    2011-01-01

    Infections of domesticated dogs by a worldwide parasitic nematode Filaroides osleri (Oslerus osleri) lead to verminous tracheobronchitis that are often misdiagnosed clinically as kennel cough, due to infection with the bacterium Bordetella bronchiseptica. Diagnosis of two canine cases in Wyoming, USA prompted a search of the literature of canid infections in North America. Infections of domestic dogs are reported in

  18. Validation of the EINTHOVEN Model-Based Computerized Electrocardiogram Rhythm Analysis System With Three Classes of Clinical Arrhythmias * * The contents of this report are solely the responsibility of the authors and do not necessarily represent the official views of the National Library of Medicine, the Oklahoma Center for the Advancement of Science of Technology, or the Whitaker Foundation. 1 1 This publication was supported in part by grants R01 LM05530 and R29 LM06004 from the National Library of Medicine, Bethesda, Maryland; project HR4-092 from the Oklahoma Center for the Advancement of Science of Technology, Oklahoma City, Oklahoma; and a grant from the Whitaker Foundation, Rosslyn, Virginia

    Microsoft Academic Search

    Lawrence E Widman; David A Tong

    1996-01-01

    Rhythm analysis by commercial systems does not meet clinical needs well, because (1) differential diagnosis of complex rhythms is not performed, (2) common rhythms are often misdiagnosed, and (3) transitions between rhythms are not described. We have developed a model-based diagnostic software system named EINTHOVEN that is designed to address the above limitations. A demonstration is available on the World

  19. Endometrial metaplasias and reactive changes: a spectrum of altered differentiation

    Microsoft Academic Search

    Alina Nicolae; Ovidiu Preda; Francisco F Nogales

    2010-01-01

    Endometrial metaplasias and changes (EMCs) are conditions frequently overlooked and misdiagnosed. The aim of this review is to update current issues and provide a classification with a practical clinicopathological approach. Hormonal or irritative stimuli are the main inducing factors of EMCs, although some metaplasias have a mutational origin. EMCs vary from reactive, degenerative lesions to those able to associate with

  20. Charcot's foot: Newest findings on its pathophysiology, diagnosis and treatment

    Microsoft Academic Search

    L. Molines; P. Darmon; D. Raccah

    2010-01-01

    Charcot neuro-osteoarthropathy (CNO) is one of the more devastating complications affecting diabetic patients with peripheral and\\/or autonomic neuropathy. The acute phase of the disease is often misdiagnosed, and can rapidly lead to deformity and amputation. The rapid progression towards foot deformation calls for early detection and intervention. Classical neurotraumatic and neurotrophic theories fail to explain all of the features of

  1. Rickettsia and Bartonella species in fleas from Reunion Island.

    PubMed

    Dieme, Constentin; Parola, Philippe; Guernier, Vanina; Lagadec, Erwan; Le Minter, Gildas; Balleydier, Elsa; Pagès, Frederic; Dellagi, Koussay; Tortosa, Pablo; Raoult, Didier; Socolovschi, Cristina

    2015-03-01

    Rickettsia felis, Rickettsia typhi, and Bartonella DNA was detected by molecular tools in 12% of Rattus rattus fleas (Xenopsylla species) collected from Reunion Island. One-third of the infested commensal rodents captured during 1 year carried at least one infected flea. As clinical signs of these zoonoses are non-specific, they are often misdiagnosed. PMID:25646263

  2. Enalapril-induced cough in the emergency department.

    PubMed

    Aggarwal, P; Wali, J P

    1992-01-01

    A case of enalapril-induced cough is reported. In the Emergency Department, the patient initially was misdiagnosed with bronchial asthma and, later, with early congestive heart failure, despite normal physical examination and investigations. The cough subsided within 5 days of cessation of enalapril. It is important to recognize this side effect in patients taking enalapril. PMID:1491150

  3. Lacrimal canaliculitis.

    PubMed

    Zaveri, Jill; Cohen, Adam J

    2014-01-01

    Canaliculitis is an uncommon, often misdiagnosed diagnosis because canaliculitis can mimic many other common ocular conditions. Canaliculitis should be appropriately diagnosed and treated to avoid recurrent inflammation and possible obstruction of the upper portion of the lacrimal system. This review will serve as a concise resource to aid in diagnosis and provide updated management options. PMID:24526851

  4. Segmental ulcerated perineal hemangioma of infancy: a complex case of PELVIS syndrome successfully treated using a multidisciplinary approach.

    PubMed

    Kaushik, Shivani B; Kwatra, Shawn G; McLean, Thomas W; Powers, Alexander; Atala, Anthony J; Yosipovitch, Gil

    2013-01-01

    We report a case of PELVIS (perineal hemangioma, external genital malformations, lipomyelomeningocele, vesicorenal abnormalities, imperforate anus and skin tag) syndrome in which hemangioma in the perineal area was misdiagnosed at birth as diaper rash. Investigations revealed associated vesicorenal and spinal abnormalities. We emphasize careful diagnosis of suspicious lesions at birth and confirm the successful use of propranolol in treating ulcerated segmental hemangiomas. PMID:23278237

  5. The Impact of Maternal Depressive Symptomatology on Ratings of Children with ADHD and Child Confederates

    ERIC Educational Resources Information Center

    Baumann, B. L.; Pelham Jr., W. E.; Lang, A. R.; Jacob, R. G.; Blumenthal, J. D.

    2004-01-01

    Some researchers who have studied children with behavior problems have suggested that depressed mothers distort reports of deviance in their children, perhaps contributing to misdiagnoses; however, investigations studying mothers with current or past depression have not clearly indicated such a bias. Because some of this equivocation may be due to…

  6. CARBON MONOXIDE POISONING--A PUBLIC HEALTH PERSPECTIVE.

    EPA Science Inventory

    Carbon monoxide (CO) may be the cause of more than one-half of the fatal poisonings reported in many countries: fatal cases also are grossly under-reported or mis-diagnosed by medical professionals. Therefore, the precise number of individuals who have suffered from CO intoxicat...

  7. An Italian case of CADASIL with mutation CGC-TCG in codon 1006, exon 19 Notch3 gene

    Microsoft Academic Search

    D. Guidetti; B. Casali; R. L. Mazzei; G. Cenacchi; G. De Berti; G. Zuccoli; D. Nicoli; F. L. Conforti; T. Sprovieri; G. Pasquinelli; M. Brini

    2004-01-01

    Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is commonly overlooked or misdiagnosed owing to its recent identification. It is characterized clinically by recurrent cerebral infarcts, usually appearing between the ages of 30 and 50 years, subcortical dementia, and pseudobulbar palsy. It begins with migraine with aura in approximately one-third of patients. The pathological hallmark of angiopathy is

  8. Identifying Hearing Loss in Young Children: Technology Replaces the Bell

    ERIC Educational Resources Information Center

    Eiserman, William; Shisler, Lenore

    2010-01-01

    Hearing loss can too easily be misdiagnosed or overlooked by providers serving young children. Parents and professionals may observe a language delay--an "invisible" condition--while failing to identify the underlying cause. Otoacoustic emissions (OAE) hearing screening technology, used extensively with newborns, is becoming an essential tool,…

  9. A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis

    Microsoft Academic Search

    V. A. Lennon; D. M. Wingerchuk; T. J. Kryzer; S. J. Pittock; C. F. Lucchinetti; K. Fujihara; I. Nakashima; B. G. Weinshenker

    2004-01-01

    BACKGROUND: Neuromyelitis optica is an inflammatory demyelinating disease with generally poor prognosis that selectively targets optic nerves and spinal cord. It is commonly misdiagnosed as multiple sclerosis. Neither disease has a distinguishing biomarker, but optimum treatments differ. The relation of neuromyelitis optica to optic-spinal multiple sclerosis in Asia is uncertain. We assessed the capacity of a putative marker for neuromyelitis

  10. Rescuing Troubled Software Projects by Team Transformation: A Case Study With an ERP Project

    Microsoft Academic Search

    Kim Man Lui; Keith C. C. Chan

    2008-01-01

    Many software projects fail, whether failure is measured in terms of budget, schedule, or some other requirement. The causes of such failures are many, but are not always easily recognized. This is not the least due to the human dimension of corporate activities, as spurious or misdiagnosed issues in Enterprise Resource Planning (ERP) projects can take on a life of

  11. Transient neonatal radial nerve palsy. A case series and review of the literature.

    PubMed

    Carsi, M Belen; Clarke, Anna M; Clarke, Nicholas P

    2015-01-01

    Transient neonatal radial nerve palsy manifests at birth by wrist drop and intact elbow and shoulder function. Spontaneous resolution is universal. We present a case series, including two bilateral cases, and a review of the cases found in the English literature, hypothesizing how this condition is probably misdiagnosed as brachial plexus injury. PMID:25835250

  12. Levels of sparganum infections and phylogenetic analysis of the tapeworm Spirometra erinaceieuropaei sparganum in wild frogs from Henan Province in central China.

    PubMed

    Wei, T; Zhang, X; Cui, J; Liu, L N; Jiang, P; Wang, Z Q

    2015-07-01

    Sparganosis is a serious food-borne parasitic zoonosis caused by infection with Spirometra spargana. The prevalence of sparganum infection in wild frogs (Rana nigromaculata, R. limmochari, R. temporaria and Bufo gargarizans) was investigated in Henan Province of central China during 2008-2012. Of 3482 caught wild frogs, 565 (16.23%) were found to be infected with plerocercoids (spargana) of the genus Spirometra. Spargana were found in 14.85% (320/2155) of R. nigromaculata, 20.82% (233/1119) of R. limmochari and 10.91% (12/110) of R. temporaria frogs. However, no sparganum was found in B. gargarizans. To investigate the phylogenetic position of collected spargana, three mitochondrial DNA (mtDNA) regions, namely cytochrome c oxidase subunits 1 and 3 (cox1 and cox3), and NADH dehydrogenase subunit 4 (nad4), were amplified, sequenced and analysed. Sequences of cox1, cox3 and pnad4 were 417, 390 and 578 bp in length, respectively. The base composition of cox1, cox3 and pnad4 were generally AT rich with a mean of 63.5%, 68.3% and 67% AT, respectively. Phylogenetic analysis showed that all the sparganum isolates in Henan Province represented Spirometra erinaceieuropaei and were a well-supported clade. These findings demonstrated clearly the usefulness of the three mtDNA sequences for molecular identification and population genetics studies of S. erinaceieuropaei spargana of human and animal health significance. PMID:26017331

  13. Serodiagnosis of Toxocariasis by ELISA Using Crude Antigen of Toxocara canis Larvae

    PubMed Central

    Jin, Yan; Shen, Chenghua; Huh, Sun; Sohn, Woon-Mok; Choi, Min-Ho

    2013-01-01

    Toxocariasis is a worldwide zoonosis caused by larvae of ascarid nematodes of dogs or cats, Toxocara canis or T. cati. Diagnosis of human toxocariasis currently relies on serology that uses T. canis excretory-secretory antigen to detect specific IgG antibodies by ELISA. We investigated the serodiagnostic efficacy of ELISA using crude antigen of T. canis larvae (TCLA). Serum specimens of 64 clinically confirmed toxocariasis, 115 healthy controls, and 119 other tissue-invading helminthiases were screened by ELISA using TCLA. The ELISA using TCLA showed 92.2% (59/64 patient samples) sensitivity and 86.6% (103/119) specificity. Its positive diagnostic predictivity was 78.7% and negative predictivity was 97.8%. No serum of healthy controls reacted but that of anisakiasis (45.5%), gnathostomiasis (19.2%), clonorchiasis (15.8%), sparganosis (11.1%), and cysticercosis (6.3%) cross-reacted. Immunoblot analysis on TCLA recognized antigenic proteins of 28- and 30-kDa bands in their dominant protein quantity and strong blotting reactivity. The present results indicate that the ELISA using our TCLA antigen is acceptable by the sensitivity and specificity for serodiagnosis of human toxocariasis. ELISA with TCLA is recommended to make differential diagnosis for patients with any sign of organ infiltration and eosinophilia. PMID:24039286

  14. The identification of a Clonorchis sinensis gene encoding an antigenic egg protein.

    PubMed

    Lee, Mejeong; Chung, Young-Bae; Lee, Suk-Keun; Chung, Byung-Suk; Li, Shunyu; Choi, Min-Ho; Hong, Sung-Tae

    2005-02-01

    The cDNA library of Clonorchis sinensis was screened for genes encoding antigenic proteins by using sera from clonorchiasis patients. A gene of 888 bp encoding a 28-kDa protein (Cs28) was cloned and found to contain a high percentage of glycine (20%), tyrosine (11%), and lysine (11%). The amino acid sequence of Cs28 showed 60% homology with the vitelline B precursor protein of Opisthorchis viverrini and of 33% homology with the vitelline B1 and B2 proteins of Fasciola hepatica. A strong positive reaction was observed in the intrauterine eggs of adult C. sinensis by immunohistochemical analysis using specific immune sera against recombinant Cs28 protein (rCs28). By immunoblot analysis, rCs28 displayed an antigenic reaction with 73% of the serum samples from 115 cases of clonorchiasis. In addition, it cross-reacted with the sera of 77.5% of 40 opisthorchiasis cases, 90% of 20 schistosomiasis cases, and 50% of 10 paragonimiasis cases. However, no cross-reactions were observed with the sera of sparganosis or cysticercosis patients. In conclusion, the Cs28 protein was identified as an egg protein of C. sinensis and as an antigen common to the trematode species examined. PMID:15616856

  15. Praziquantel Treatment in Trematode and Cestode Infections: An Update

    PubMed Central

    2013-01-01

    Status and emerging issues in the use of praziquantel for treatment of human trematode and cestode infections are briefly reviewed. Since praziquantel was first introduced as a broadspectrum anthelmintic in 1975, innumerable articles describing its successful use in the treatment of the majority of human-infecting trematodes and cestodes have been published. The target trematode and cestode diseases include schistosomiasis, clonorchiasis and opisthorchiasis, paragonimiasis, heterophyidiasis, echinostomiasis, fasciolopsiasis, neodiplostomiasis, gymnophalloidiasis, taeniases, diphyllobothriasis, hymenolepiasis, and cysticercosis. However, Fasciola hepatica and Fasciola gigantica infections are refractory to praziquantel, for which triclabendazole, an alternative drug, is necessary. In addition, larval cestode infections, particularly hydatid disease and sparganosis, are not successfully treated by praziquantel. The precise mechanism of action of praziquantel is still poorly understood. There are also emerging problems with praziquantel treatment, which include the appearance of drug resistance in the treatment of Schistosoma mansoni and possibly Schistosoma japonicum, along with allergic or hypersensitivity reactions against praziquantel treatment. To cope with and overcome these problems, combined use of drugs, i.e., praziquantel and other newly introduced compounds such as triclabendazole, artemisinins, and tribendimidine, is being tried. PMID:24265948

  16. Praziquantel treatment in trematode and cestode infections: an update.

    PubMed

    Chai, Jong-Yil

    2013-03-01

    Status and emerging issues in the use of praziquantel for treatment of human trematode and cestode infections are briefly reviewed. Since praziquantel was first introduced as a broadspectrum anthelmintic in 1975, innumerable articles describing its successful use in the treatment of the majority of human-infecting trematodes and cestodes have been published. The target trematode and cestode diseases include schistosomiasis, clonorchiasis and opisthorchiasis, paragonimiasis, heterophyidiasis, echinostomiasis, fasciolopsiasis, neodiplostomiasis, gymnophalloidiasis, taeniases, diphyllobothriasis, hymenolepiasis, and cysticercosis. However, Fasciola hepatica and Fasciola gigantica infections are refractory to praziquantel, for which triclabendazole, an alternative drug, is necessary. In addition, larval cestode infections, particularly hydatid disease and sparganosis, are not successfully treated by praziquantel. The precise mechanism of action of praziquantel is still poorly understood. There are also emerging problems with praziquantel treatment, which include the appearance of drug resistance in the treatment of Schistosoma mansoni and possibly Schistosoma japonicum, along with allergic or hypersensitivity reactions against praziquantel treatment. To cope with and overcome these problems, combined use of drugs, i.e., praziquantel and other newly introduced compounds such as triclabendazole, artemisinins, and tribendimidine, is being tried. PMID:24265948

  17. Helminth infections of the central nervous system occurring in Southeast Asia and the Far East.

    PubMed

    Lv, Shan; Zhang, Yi; Steinmann, Peter; Zhou, Xiao-Nong; Utzinger, Jürg

    2010-01-01

    Although helminth infections of the central nervous system (CNS) are rare, their public health implications must not be neglected. Indeed, several helminth species can cause cerebrospinal infections, especially if humans serve as intermediate or non-permissive host. The diagnosis of cerebrospinal helminthiases is difficult, and the detection of parasites in cerebrospinal fluid is rarely successful. Cerebrospinal helminth infections therefore often remain undetected, and hence prognosis is poor. Increases in tourism and population movements are risk factors for cerebrospinal helminthiases and infections pose particular challenges to clinicians in non-endemic areas. In this review, we focus primarily on food-borne helminthiases that are endemic and often emerging in Southeast Asia and the Far East, namely angiostrongyliasis, gnathostomiasis, sparganosis, paragonimiasis and cysticercosis. Additionally, we discuss neuroschistosomiasis, a disease that is transmitted through human-water contact. For each disease, we describe the pathogen, its transmission route and possible mechanisms for entering the CNS. We also summarise common signs and symptoms, challenges and opportunities for diagnosis, treatment, clinical management, geographical distribution and epidemiology. The adoption of a comprehensive set of diagnostic criteria for different cerebrospinal helminthiases is proposed, including epidemiological history, typical signs and symptoms, neuroimaging and laboratory findings. Finally, risk factors, and research needs for enhanced patient management and population-based control measures are discussed. PMID:20624537

  18. Technical note: A noninvasive urine collection device for female cattle: modification of the urine cup collection method.

    PubMed

    Lascano, G J; Zanton, G I; Heinrichs, A J; Weiss, W P

    2010-06-01

    Total urine collection from female cattle requires the use of indwelling urinary catheters or an external device requiring secure attachment with adhesive to the animal; neither method is ideal for the welfare of the cattle. A urine collection device was developed to enable total urine collection in female dairy cattle without the use of adhesive to attach the device to the vulva of the animal; the device was a modification of one described previously for female cattle. The urine collection device was made from polypropylene with maximum dimensions (height x width x depth) of 17.5 x 11.0 x 6.0 cm and an opening of approximately 42 cm(2) to cover the vulva. The device was secured using a commercially available udder support harness that provided snap-fasteners and support for the device to be positioned at the level of the vulva. At the point of attachment, a metal brace surrounded the device and was connected to the udder support by metal rings, which kept the urine cup in proper position as the animal arched to urinate. A metal O-clamp and pieces of rubber, serving as leak-proof washers, connected the bottom of the device to Gooch tubing. Another metal clamp was attached to a polyvinyl chloride adapter that was connected to a rubber hose, and urine was collected into carboys located on the floor approximately 1.5 m behind the animals. This modification of a urine cup allows several noninvasive total feces and urine collection studies of unrestricted length to be undertaken without the use of adhesive to attach the device. The floor-level collection system is a practical, portable, and handy system that will permit researchers to perform nutrient balance and metabolic studies on female cattle. PMID:20494178

  19. Primary Localization and Tumor Thickness as Prognostic Factors of Survival in Patients with Mucosal Melanoma

    PubMed Central

    Mehra, Tarun; Grözinger, Gerd; Mann, Steven; Guenova, Emmanuella; Moos, Rudolf; Röcken, Martin; Claussen, Claus Detlef; Dummer, Reinhard; Clasen, Stephan

    2014-01-01

    Background Data on survival with mucosal melanoma and on prognostic factors of are scarce. It is still unclear if the disease course allows for mucosal melanoma to be treated as primary cutaneous melanoma or if differences in overall survival patterns require adapted therapeutic approaches. Furthermore, this investigation is the first to present 10-year survival rates for mucosal melanomas of different anatomical localizations. Methodology 116 cases from Sep 10 1984 until Feb 15 2011 retrieved from the Comprehensive Cancer Center and of the Central Register of the German Dermatologic Society databases in Tübingen were included in our analysis. We recorded anatomical location and tumor thickness, and estimated overall survival at 2, 5 and 10 years and the mean overall survival time. Survival times were analyzed with the Kaplan-Meier method. The log-rank test was used to compare survival times by localizations and by T-stages. Principal Findings We found a median overall survival time of 80.9 months, with an overall 2-year survival of 71.7%, 5-year survival of 55.8% and 10-year survival of 38.3%. The 10-year survival rates for patients with T1, T2, T3 or T4 stage tumors were 100.0%, 77.9%, 66.3% and 10.6% respectively. 10-year survival of patients with melanomas of the vulva was 64.5% in comparison to 22.3% of patients with non-vulva mucosal melanomas. Conclusion Survival times differed significantly between patients with melanomas of the vulva compared to the rest (p?=?0.0006). It also depends on T-stage at the time of diagnosis (p<0.0001). PMID:25383553

  20. Pulmonary intravascular talcosis mimicking miliary tuberculosis in an intravenous drug addict.

    PubMed

    Altraja, Alan; Jürgenson, Katre; Roosipuu, Retlav; Laisaar, Tanel

    2014-01-01

    Pulmonary foreign body granulomatosis following intravenous administration of medications meant for oral use among drug addicts has been occasionally reported. This condition is often misdiagnosed because of its rarity, but rather due to its similarity to other pulmonary diseases that are more common. Here we report a case of pulmonary intravascular talcosis mimicking miliary tuberculosis in a young male intravenous drug addict from North-Eastern Estonia, known as a hotspot for tuberculosis and drug misuse. The condition was caused by intravenous administration of crushed tablets of diphenhydramine, but miliary tuberculosis was misdiagnosed on patient's demographical, clinical and radiological grounds and a decision to start treatment with four first-line antituberculosis drugs followed. The current report refers to the importance of considering rare causes of pulmonary disseminations with attempts to identify the causative agent and warns against the use of antituberculosis treatment without confirmation of microbiological diagnosis of tuberculosis. PMID:24713715

  1. Young girl with abnormal behavior: Anti-N-Methyl-D-Aspartate receptor immune encephalitis

    PubMed Central

    Suri, Vinit; Sharma, Sushma; Gupta, Rohan; Jadhao, Nilesh; Suri, Kunal

    2013-01-01

    Anti N Methyl D Aspartate receptor immune encephalitis (Anti NMDARE) is a recently defined, under-recognized and often misdiagnosed disease, which typically occurs in young females and may be associated with an underlying tumor, usually ovarian teratoma. If diagnosed early, initiation of immunotherapy and tumor removal (if present) may result in recovery. We report a case of a 17 years old girl with Anti NMDARE who was initially misdiagnosed as Functional psychosis, Neuroleptic Malignant Syndrome and Sepsis syndrome. To the best of our knowledge, this is only the second case of anti NMDARE being reported from India. This case report underscores the need for a greater awareness of this entity across multiple specialties, e.g., general medicine, psychiatry and neurology, to ensure a heightened diagnostic suspicion, which can lead to timely diagnosis and adequate therapy of this treatable disease. PMID:23956557

  2. Acute Spontaneous Spinal Subdural Hematoma with Vague Symptoms

    PubMed Central

    Chung, Jaehwan; Hwang, Soo-Hyun; Han, Jong-Woo

    2014-01-01

    Spinal subdural hematoma is a rarely reported disease and spontaneous spinal subdural hematomas (SSDH) without underlying pathological changes are even rarer. The patients usually show typical symtoms such as back pain, quadriplegia, paraplegia or sensory change. But rarely, patients may show atypical symptoms such as hemiparesis and misdiagnosed to cerebrovascular accident. We recently experienced a case of SSDH, where the patient initially showed vague symptoms, such as the sudden onset of headache which we initially misdiagnosed as subarachnoid hemorrhage. In this case, the headache of patient improved but the neck pain persisted until hospital day 5. Therefre, we conducted the MRI of cervical spine and finally confirmed SSDH. The patient was managed conservatively and improved without recurrence. In this case report, we discuss the clinical features of SSDH with emphasis on the importance of an early diagnosis. PMID:25368774

  3. Acute spontaneous spinal subdural hematoma with vague symptoms.

    PubMed

    Chung, Jaehwan; Park, In Sung; Hwang, Soo-Hyun; Han, Jong-Woo

    2014-09-01

    Spinal subdural hematoma is a rarely reported disease and spontaneous spinal subdural hematomas (SSDH) without underlying pathological changes are even rarer. The patients usually show typical symtoms such as back pain, quadriplegia, paraplegia or sensory change. But rarely, patients may show atypical symptoms such as hemiparesis and misdiagnosed to cerebrovascular accident. We recently experienced a case of SSDH, where the patient initially showed vague symptoms, such as the sudden onset of headache which we initially misdiagnosed as subarachnoid hemorrhage. In this case, the headache of patient improved but the neck pain persisted until hospital day 5. Therefre, we conducted the MRI of cervical spine and finally confirmed SSDH. The patient was managed conservatively and improved without recurrence. In this case report, we discuss the clinical features of SSDH with emphasis on the importance of an early diagnosis. PMID:25368774

  4. Maternal mortality in a rural Tanzanian hospital: fatal Jarisch-Herxheimer reaction in a case of relapsing fever in pregnancy.

    PubMed

    Rustenhoven-Spaan, Ilona; Melkert, Peter; Nelissen, Ellen; van Roosmalen, Jos; Stekelenburg, Jelle

    2013-10-01

    Relapsing fever is a disease caused by one of the species of Borrelia. It is often misdiagnosed as malaria and can have fatal complications such as the Jarisch-Herxheimer reaction (JHR) after the commencement of treatment with antibiotics. A 19-year-old Tanzanian woman was admitted after a term home delivery that day. She presented with a 2 day history of fever, headache, general body malaise and vomiting. She was misdiagnosed as having severe malaria and was treated with quinine. The blood slide showed Borrelia duttoni. The patient continued treatment with procaine penicillin fortified for relapsing fever. Several hours later the woman died, probably due to JHR. This case of a patient with relapsing fever who died from a JHR stresses the importance of adequate diagnosis and treatment which should include careful monitoring, especially for the first hours after starting antibiotics. PMID:23976777

  5. Pilomatrix carcinoma on the left side of the parotid region: A case report and review of the literature

    PubMed Central

    LIU, JI-FENG; LI, BIN; FAN, ZI-XUAN; JIAO, TING; LI, CHAO; QIN, SHENG; LANG, JIN-YI; CHEN, JIN-XIU

    2015-01-01

    Pilomatrix carcinoma (PC) is a rare neoplasm, particularly in the parotid region. Thus, it is easily misdiagnosed and an optimal treatment regimen has not yet been established. The present study reports the case of a 43-year-old female who presented with a PC of the parotid region and reviews the associated published literature. The patient underwent three surgical excisions prior to the tumor being completely removed, and was misdiagnosed four times prior to the correct diagnosis. Once the tumor was completely removed, the patient received radiation therapy (RT). At the 2-year follow-up, the patient remained free of local recurrence and metastasis. To the best of our knowledge, only 3 cases of PC on the parotid region have been reported. Although an optimal treatment regimen has not been established, surgery with wide margins is recommended, with RT and chemotherapy producing mixed results. PMID:26171021

  6. Update in Cancer Chemotherapy: Genitourinary Tract Cancer, Part 3: Cancer of the Prostate

    PubMed Central

    Wright, Jane C.

    1988-01-01

    An update of the state of the art of cancer chemotherapeutic treatment of genitourinary tract cancer is described in this multi-part series: included are cancers of the kidney, bladder, prostate, testicle, ovary, uterus, vulva, and gestational trophoblastic neoplasms. Part 3 is a review of treatments for cancer of the prostate. The role of cancer chemotherapeutics as adjuvant therapy and in combination modalities in the treatment of prostatic carcinoma has yet to be determined. No single agent or combination can be considered standard therapy. The role of chemotherapy in prostatic carcinoma needs further definition. Only through randomized trials will better guides to better treatment be established. PMID:3280813

  7. Rhizonema sequoiae n.gen. n.sp. from Coast Redwood Sequoia sempervirens (D.Don) Endl.

    PubMed

    Del Prado Vera, I C; Lownsbery, B F; Maggenti, A R

    1983-07-01

    Rhizonema sequoiae n.gen, u. sp. is described from the roots of Coast Redwood, Sequoia sempervirens (D. Don) Endl., growing near Lake Lagunitas, Marin County, California. Rhizonema females are annulated over their entire bodies, are wholly embedded in host tissue, and secrete an abundant amount of gel material. Mature females do not form a cyst. The vulva is located on a large posterior terminal cone, and the anus is on the dorsal vulval lip. Esophageal glands of the second-stage larvae fill more than half of the body cavity. Tails of the vermiform males are blunt, and a cloacal tubus is present. PMID:19295834

  8. Extremely rare case of vulvar myxoid epithelioid sarcoma.

    PubMed

    Rego, Joana Lima; Cintra, Georgia Fontes; Netto, Ana Karina Junqueira; Abrahão-Machado, Lucas Faria; Tsunoda, Audrey

    2015-01-01

    Epithelioid sarcoma is a distinct sarcoma type with specific morphology and immunophenotype. An epithelioid sarcoma of the vulva is an extremely rare and aggressive tumor and most commonly occurs on the labia majora in women of reproductive age. Only few cases have been reported, especially with the presence of focal myxoid changes. Early diagnosis is difficult because of its benign appearance as a painless subcutaneous nodule. Optimal treatment is not well established due to its rarity. We report a successfully approached case of vulvar epithelioid sarcoma that occurred in a 34-year-old female patient, treated with wide local excision, and review of the current medical literature. PMID:25737787

  9. Artificial Insemination in Swine 

    E-print Network

    Sterle, Jodi

    1999-09-03

    or at the time of standing heat. The vulva leads to the vagina, which tapers into the cervix. The cervix con- sists of multiple rings and ridges that act as a barrier to prevent bacteria, dirt and other foreign material from entering the uterus. During estrus..., the cervix becomes swollen. This allows the AI spirette or catheter to be ?locked? into it. A spirette is a spiral-shaped, plastic- tipped insemination rod; a catheter is a foam-tipped insemination rod. This locking prevents some semen backflow and initiates...

  10. Neyraiella distinctus n. sp. (Oxyurida, Blattophilidae) parasite of nymphs of Gryllodes laplatae Sauss (Orthoptera, Gryllidae) in Argentina.

    PubMed

    Camino, Nora B; de Villalobos, Cristina

    2002-04-01

    Neyraiella distinctus n. sp. was found parasitizing nymphs of the cricket Gryllodes laplatae Sauss in City Bell, Argentina. This species was characterized by having the excretory pore in the posterior end of the basal bulb, vulva protruding with one lip well developed in the 1/3 end of the body, anus of the female with wings, male with a single spicule without any sculpture, gubernaculum and bursa are absent, six pairs of genital papillae arranged in two preanal pairs, one adanal pair and three postanal pairs, and the tail appendage in both sexes was short and conic. PMID:12048559

  11. Living with contradictions--Hannah Wilke.

    PubMed

    Barry, J

    1998-06-01

    The late Hannah Wilke was a feminist artist whose work chronicled the ever-changing thoughts about women's bodies and self-image. Wilke was a performance artist and also produced sculpture, videos and photographs throughout a 30-year career. She was among the first to feature female genitalia prominently in her art, and competed with Judy Chicago in introducing a series of artwork highlighting vulvas. Toward the end of her career, after she had been diagnosed with lymphoma, she produced a series of 13 self-portrait photographs displaying her body after chemotherapy and bone marrow treatments. PMID:11365533

  12. Sclerosing ductal carcinoma of the clitoris with microcystic adnexal carcinoma-like features.

    PubMed

    DuPont, Nefertiti C; Mabuchi, Seiji; Ries, Savita; Berman, Michael L

    2009-03-01

    Primary clitoral malignancies are rare and most are invasive squamous cell carcinomas. Microcystic adnexal carcinoma (MAC) is an indolent, rare dermatologic carcinoma that typically affects the head and neck region. A 23-year-old nulligravid Hispanic female presented with a 9-month history of an enlarging periclitoral mass. After surgical resection, the mass was diagnosed as a MAC. MAC is a cutaneous carcinoma rarely found on the vulva. It is a slow growing but locally aggressive carcinoma that is best treated with surgical resection. Sclerosing ductal carcinomas may have MAC-like features, and the diagnosis and management of one case is provided here. PMID:19220633

  13. Vulvar Langerhans cell histiocytosis: a case report

    PubMed Central

    Khoummane, Nadia; Guimeya, Cyriane; Lipombi, Dominique; Gielen, François

    2014-01-01

    Langerhans cell histiocytoses (LCH) are a rare group of disorders that comprise a large spectrum of diseases initially known as histiocytosis X. In this case report, we relate a case of LCH affecting the vulva of a 47-year-old female. The patient presented since 3 years with a vulvar lesion characterized by non-healing ulcers and a perineal granuloma on which she underwent surgery. Professionals should keep in mind not to treat straightforwardly lesions of the genital tract as simple sexually transmitted diseases. Chronic, atypical genital lesions seen in women need to be worked up and dealt with accordingly. PMID:25404979

  14. The example of the IPCC does not vindicate the Value Free Ideal: a reply to Gregor

    E-print Network

    John, Stephen

    2014-08-07

    enough” to warrant policy- makers’ adoption. §3 How deep does the methodological critique go? Even if Betz has misdiagnosed the force of the methodological critique, maybe he has found a way to avoid it. Unfortunately, in this section I... ) Is a little pollution good for you? London: Oxford University Press Hansen, J (2007) “Scientific reticence and sea level rise” Environmental Research Letters 2(2) (April-June 2007) IPCC (2013a) “Activities” web-page at http...

  15. Cholestrol emboli syndrome: acute renal insufficiency after a procedure or a thrombolytic therapy or anticoagulant therapy.

    PubMed

    Sekhar, C Chandra; Jindal, Parveen; Karna, V Guru; Aggarwala, Manoj; Sekhar, Soma

    2013-06-01

    Cholesterol emboli syndrome is due to dislodgment of cholesterol crystals from the atherosclerotic plaques lining the walls of major arteries resulting in an occlusion of small arteries. We describe a case of severe cutaneous and renal cholesterol emboli syndrome following coronary angiography showing our observation that this syndrome is often unrecognized or misdiagnosed and that a better evaluation of risks factors in patients undergoing invasive procedures could prevent this severe complication. PMID:24426640

  16. Scrotal Extraperitoneal Hernia of the Ureter: Case Report and Literature Review

    Microsoft Academic Search

    Matteo Giglio; Mauro Medica; Francesco Germinale; Matteo Raggio; Fabio Campodonico; Robert Stubinski; Giorgio Carmignani

    2001-01-01

    Ureteral herniation is a rare, often misdiagnosed event and serious surgical complications are possible. Until 1992, 128 cases of ureteral herniation were reported and in 54 (42%) the inguino-scrotal region was involved. From an anatomical and pathogenic standpoint, two types of uretero-inguinal hernias can be identified: paraperitoneal (more frequent, acquired, always presenting a peritoneal hernia sac, frequently associated with other

  17. Delivery Induced Intraperitoneal Rupture of a Cystic Ovarian Teratoma and Associated Chronic Chemical Peritonitis

    PubMed Central

    Nader, Reine; Thubert, Thibault; Deffieux, Xavier; de Laveaucoupet, Jocelyne; Ssi-Yan-Kai, Guillaume

    2014-01-01

    Intraperitoneal rupture of cystic ovarian teratoma is a rare complication. We report a case in a 29-year-old female, with increased abdominal circumference 2 months after vaginal delivery. MRI/CT raised this diagnosis associated to chemical peritonitis. A malignant ovarian mass with peritoneal carcinomatosis was excluded. Laparoscopic oophorectomy was performed and histologic analysis confirmed imaging findings. This case demonstrates the interest of imaging before surgery in pelvic masses to avoid misdiagnosing and to provide adequate treatment. PMID:24744942

  18. Evaluation of Three Techniques for Detection of Low-Level Methicillin-Resistant Staphylococcus aureus (MRSA): a Disk Diffusion Method with Cefoxitin and Moxalactam, the Vitek 2 System, and the MRSA-Screen Latex Agglutination Test

    Microsoft Academic Search

    Annie Felten; Bernadette Grandry; Philippe Henri Lagrange; Isabelle Casin

    2002-01-01

    Very-low-level methicillin-resistant Staphylococcus aureus (MRSA), or class 1 MRSA, is often misdiagnosed as methicillin-susceptible S. aureus (MSSA). We evaluated the performances of three methods for detection of low-level methicillin resistance: the disk diffusion method using the cephamycin antibiotics cefoxitin and moxalactam, the Vitek 2 system (bioMerieux), and the MRSA-screen test (Denka). Detection of the mecA gene by PCR was considered

  19. A case of pseudogout of the temporomandibular joint with giant cell reparative granuloma of the temporal bone.

    PubMed

    Lv, Huaiqing; Fan, Zhaomin; Han, Yuechen; Xu, Lei; Wang, Haibo

    2013-01-01

    Pseudogout, also known as calcium pyrophosphate dihydrate deposition disease (CPPD) with giant cell reparative granuloma (GCRG) of the temporal bone is a rare disease, which is very easy to misdiagnose. When two diseases occur simultaneously, the pathological tissue of diseases is closely associated, which complicates clinical representation and causes enormous difficulty in diagnosis and treatment. We report a case of CPPD of the temporomandibular joint accompanied by surrounding GCRG of temporal bone in a 62-year-old male. PMID:23969082

  20. Anterior cruciate ligament reconstruction complicated by pyoderma gangrenosum.

    PubMed

    Bagouri, E; Smith, Jon; Geutjens, G

    2012-11-01

    We report a case of pyoderma gangrenosum as a complication of an anterior cruciate ligament reconstruction in a patient with inflammatory bowel disease, which was misdiagnosed initially as a post-operative wound infection. An early dermatology opinion and skin biopsy should be considered in cases of suspected infection where thorough surgical debridement and antimicrobial therapy has failed to improve the clinical picture. PMID:23131219

  1. Advanced Clinical Interpretation of the WAIS-IV and WMS-IV: Prevalence of Low Scores Varies by Level of Intelligence and Years of Education

    Microsoft Academic Search

    Brian L. Brooks; James A. Holdnack; Grant L. Iverson

    2011-01-01

    Clinicians can use the base rates of low scores in healthy people to reduce the likelihood of misdiagnosing cognitive impairment. In the present study, base rates were developed for the Wechsler Adult Intelligence Scale—Fourth Edition (WAIS-IV) and Wechsler Memory Scale—Fourth Edition (WMS-IV) using 900 healthy adults and validated on 28 patients with moderate or severe traumatic brain injuries (TBIs). Results

  2. Traumatic bilateral quadriceps tendon rupture

    Microsoft Academic Search

    Lars Hansen; Søren Larsen; Troels Laulund

    2001-01-01

    Bilateral spontaneous quadriceps tendon rupture is a very rare event, with only an estimated 40 cases reported in the literature.\\u000a We report a case of bilateral spontaneous quadriceps tendon rupture and review the literature. The reviewed literature recommends\\u000a early repair; therefore, early diagnosis is crucial. Reportedly, up to 50% of spontaneous bilateral quadriceps ruptures are\\u000a misdiagnosed at first, resulting in

  3. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines

    Microsoft Academic Search

    Francois Lintz; Nicolas Pujol; Philippe Boisrenoult; Kevin Bargoin; Philippe Beaufils; David Dejour

    2011-01-01

    Purpose  Anterior cruciate ligament (ACL) mucoid degeneration is a rare encounter in clinical practice, different, but often confused\\u000a with ACL mucoid cysts. Its pathophysiology remains unclear. However, recent publications have suggested that it might be underdiagnosed\\u000a or misdiagnosed, and that the adverse effects of treatment by ACL resection might be underestimated. The object of this work\\u000a was to summarize this scattered

  4. A 15-cm aneurysm of the right coronary artery presenting as a pericardial cyst

    PubMed Central

    Burnside, Nathan; Nzewi, Onyekwelu C.; Sidhu, Pushpinder Singh

    2012-01-01

    We report an unusual case of a giant right coronary artery aneurysm, measuring 15 cm in diameter, in a 76-year old woman. The aneurysm was initially identified when the patient was investigated for signs of congestive cardiac failure with a computed tomography scan of her thorax; at this stage, the lesion was misdiagnosed as a large pericardial cyst. The aneurysm was successfully excised at surgery and her heavily diseased right coronary artery was secured with a saphenous vein graft. PMID:22228289

  5. Anti-N-methyl-D-aspartate receptor encephalitis: A case report and review of the literature

    PubMed Central

    Kaur, Satnam; Juneja, Monica; Mishra, Devendra; Jain, Silky

    2014-01-01

    Anti-N-methyl-D-aspartate receptor encephalitis is a well characterized immune-mediated encephalitis. It is increasingly being recognized as one of the common causes of encephalitis, but is frequently misdiagnosed especially in resource-constrained settings. With a simple test available to diagnose the disorder and prospects of good recovery following early immunotherapy, the disorder should be kept as a differential diagnosis in patients presenting with unexplained behavioral/psychiatric symptoms and progressive encephalopathy with movement disorders. PMID:25250071

  6. Retinoblastoma in Adults: a Case Report and Literature Review

    PubMed Central

    Sharifzadeh, Mehdi; Ghassemi, Fariba; Amoli, Fahimeh Asadi; Rahmanikhah, Elham; Tabatabaie, Seid Zia

    2014-01-01

    Purpose: To report a case of adult retinoblastoma with a wrong diagnosis of melanoma. Case report: Herein, we present an adult retinoblastoma case who was misdiagnosed as melanoma in fine-needle aspiration biopsy with intravitreal hemorrhage and later neovascular glaucoma after biopsy. The diagnosis of retinoblastoma was confirmed after enucleation. Conclusion: Retinoblastoma should be considered in the differential diagnosis of an intraocular mass in adults, especially when media haziness precludes adequate ophthalmoscopic visualization. PMID:25667742

  7. Skin to Serosa: Scar Endometrioma

    PubMed Central

    T.A., Sridevi; P.N., Chandrika; Selvakumar A., Sathish

    2014-01-01

    Extra pelvic endometriosis, an underappreciated and misdiagnosed gynaecological problem has been reported here for its rare location. Patient presented with swelling and cyclical pain over vertical scar (caesarean). Diagnosis was made on high index of clinical suspicion which was complimented by Magnetic Resonance Imaging (MRI). Scar endometrioma extended from the skin upto the uterine serosa which is extremely rare. Wide excision of endometrioma followed by mesh repair was done. Histopathology confirmed the diagnosis. PMID:25478414

  8. Misdiagnosis of menstruation-related recurrent hypersomnia as epilepsy in a patient with generalized epileptic discharges

    PubMed Central

    Benbir, Gulcin; Delil, Sakir; Karadeniz, Derya; Yeni, Naz

    2015-01-01

    Recurrent hypersomnias are very rare with two subtypes as Kleine–Levin syndrome and menstruation-related hypersomnia, which is very rarely encountered worldwide. Here, we report a young girl with menstruation-related recurrent hypersomnia, who was misdiagnosed as epilepsy due to co-existing generalized epileptic discharges. The importance of this comorbidity in terms of differential diagnosis of the attacks is discussed. PMID:25878739

  9. Fishbone-associated actinomycosis of the anterior cervical space: a diagnostic dilemma.

    PubMed

    Lee, Sang Kwon; Kim, Mi Jeong; Kwon, Sun Young

    2010-01-01

    We report the imaging and pathologic findings of fishbone-associated actinomycosis of the anterior cervical space in a 57-year-old man, misdiagnosed preoperatively as a malignancy originating from thyroglossal duct cyst. CT revealed an enhancing mass containing a small abscess pocket and two sharp linear calcifications within it, which infiltrated into the strap muscle. Pathologic examination demonstrated two fishbones within the actinomycotic abscess. Fishbone-associated actinomycosis should be considered when a cervical mass contains sharp linear calcifications. PMID:21113303

  10. A Review of Neospora caninumand Neospora-like Infections in Animals

    Microsoft Academic Search

    J. P. Dubey

    ABSTRACT: Neospora caninum is a recently recognized protozoan parasite of animals. Until 1988, it was misdiagnosed ,as Toxoplasma,gondii. Neospora caninum or Neospora-like parasites cause paralysis and death in dogs and neonatal mortality and abortion in cattle, sheep, goats and horses. Its life cycle is not known. Tachyzoites and tissue cysts are the only asexual stages known,and the carnivorous definitive host

  11. Psoriasis first presenting around an enteral feeding tube in three pediatric patients: an important consideration for timely diagnosis and management.

    PubMed

    Zitelli, Kristine B; Lucky, Anne W

    2014-01-01

    Pediatric dermatologists may care for patients with percutaneous enteral feeding tubes. Although ostomy complications such as allergic contact and irritant dermatitis are common, psoriasis may be misdiagnosed. We report three novel cases of childhood psoriasis first presenting around an enteral feeding tube site. Localized psoriasis is an important clinical consideration in children with ostomy site eruptions to ensure timely diagnosis and effective management. PMID:23937450

  12. Endovascular treatment of vein of Galen dural arteriovenous fistula presenting as dementia

    PubMed Central

    Huded, Vikram; Moeed, Syed Zafer; Desouza, Romnesh; Tripathi, Ravikesh; Nair, Rithesh

    2014-01-01

    Dural arteriovenous fistula (DAVF) is an important cause of neurological dysfunction that is often misdiagnosed, especially in elderly population. Galenic DAVFs are a subtype of the rare falcotentorial DAVFs with a high risk of hemorrhage and aggressive clinical course. In most cases, DAVFs present with pulsatile tinnitus, headache, or orbital symptoms such as chemosis and proptosis. We report a patient with DAVF of Vein of Galen presented with progressive dementia, treated by Onyx embolisation and had good clinical outcome. PMID:25506172

  13. Hair casts.

    PubMed

    Parmar, Sweta S; Parmar, Kirti S; Shah, Bela J

    2014-10-01

    Hair casts or pseudonits are circumferential concretions, which cover the hair shaft in such a way that, it could be easily removed. They are thin, cylindrical, and elongated in length. We present an unusual case of an 8-year-old girl presenting with hair casts. Occurrence of these is unusual, and they may have varied associations. This patient was suffering from developmental delay. It is commonly misdiagnosed as and very important to differentiate from pediculosis capitis. PMID:25396168

  14. Blister beetle dermatitis.

    PubMed

    Narasimhalu, C R V; Murali, A; Kannan, R; Srinivasan, N

    2010-11-01

    Blister beetle dermatitis or paederus dermatitis is an irritant contact dermatitis due to accidental crush of insects belonging to paederus family on the skin. The characteristic features of blister beetle dermatitis are linear erythematous itchy vesicles over the exposed parts of body and kissing lesions. This condition is commonly seen during or after rainy season. The treatment is removal of irritant by gentle washing and topical steroids. It is often misdiagnosed and causes significant morbidity among the rural population. PMID:21510580

  15. Diffuse infiltrative neurofibroma: a clinical, radiological, and histological conundrum.

    PubMed

    Ravi, Ananth K; Ram, Roopa; Lindberg, Matthew R; Pandey, Tarun

    2014-12-01

    Diffuse infiltrative neurofibroma is a rare clinical entity that can pose a diagnostic challenge not only due to its rarity but also due to its varied clinical, radiological, and histological features. Our case illustrates how this entity may be misdiagnosed on clinical and pathological examination. Radiological imaging plays a critical and collaborative role in guiding clinicians and pathologists when faced with this challenging diagnosis. PMID:25081636

  16. Combination capecitabine and bevacizumab in the treatment of metastatic hepatic epithelioid hemangioendothelioma

    PubMed Central

    Malangone, Steve; Green, Myke; Badari, Ambuga; Clarke, Kathryn; Elquza, Emad

    2015-01-01

    Hepatic epithelioid hemangioendothelioma (HEHE) is a rare, often misdiagnosed vascular neoplasm with clinical behaviors that range from indolent to highly aggressive. Even when the appropriate diagnosis is achieved, the best treatment for HEHE has not been defined or standardized, further complicating the care of these patients. We present a diagnostically challenging case of HEHE where we utilized capecitabine and bevacizumab as another novel treatment option. PMID:26136854

  17. Whipple’s Disease—Generalized Stage

    Microsoft Academic Search

    Peter Jackuliak; Tomas Koller; Lahim Baqi; Lukas Plank; Zora Lasabova; Gabriel Minarik; Juraj Payer

    2008-01-01

    Whipple’s disease is a chronic inflammatory systemic disorder in which all organs can be invaded by the rod-shaped bacterium\\u000a Tropheryma whipplei. It is a rare disease and frequently misdiagnosed, though there is no valid estimate of its actual incidence and prevalence.\\u000a Only about 1,000–1,500 cases have been reported. The clinical course of untreated Whipple’s disease can include three stages:\\u000a (1)

  18. Induction of pluripotent stem cells from autopsy donor-derived somatic cells

    Microsoft Academic Search

    Brooke E. Hjelm; Jon B. Rosenberg; Szabolcs Szelinger; Lucia I. Sue; Thomas G. Beach; Matthew J. Huentelman; David W. Craig

    2011-01-01

    Human induced pluripotent stem cells (iPSCs) have become an intriguing approach for neurological disease modeling, because neural lineage-specific cell types that retain the donors’ complex genetics can be established in vitro. The statistical power of these iPSC-based models, however, is dependent on accurate diagnoses of the somatic cell donors; unfortunately, many neurodegenerative diseases are commonly misdiagnosed in live human subjects.

  19. Invasive pneumococcal infection despite 7-valent conjugated vaccine

    PubMed Central

    Joye, Sebastien; Gao, Anja; Kayemba-Kay’s, Simon; Cotting, Jacques; Perez, Marie-Hélène

    2013-01-01

    Despite good cover with 7-valent vaccination, invasive pneumococcal infections may still be misdiagnosed and may lead to lifethreatening situations or death in young children. New serotypes are emerging and, therefore, clinicians must keep a high level of suspicion in young children regardless of their vaccination status. We report three cases of invasive pneumococcal infection due to new serotypes not covered by the 7-valent conjugated vaccine, two of which led children to death. PMID:24765491

  20. Pharmacotherapy of bipolar depression: An update

    Microsoft Academic Search

    Michael E. Thase

    2006-01-01

    Bipolar affective disorder is a virulent illness with high rates of recurrence, disability, social impairment, and suicide.\\u000a Although the manic or hypomanic episodes define the disorder, the depressions are more numerous and less responsive to treatment.\\u000a As the initial depressive episodes are commonly misdiagnosed, initiation of therapy with mood stabilizers is often delayed,\\u000a increasing the likelihood of treatment-emergent affective switches

  1. The Clinical and Molecular Heterogeneity of 17?HSD-3 Enzyme Deficiency

    Microsoft Academic Search

    Minu M. George; Maria I. New; Svetlana Ten; Charles Sultan; Amrit Bhangoo

    2010-01-01

    17-?-hydroxysteroid dehydrogenase type 3 (17?HSD-3) deficiency is a rare, but frequently misdiagnosed autosomal recessive cause of 46,XY disorder of sex development (DSD). 17?HSD-3 enzyme is present almost exclusively in the testes and converts ?4-androstenedione (?4) to testosterone (T). The diagnosis can be easily missed in early childhood as the clinical presentation may be subtle. Any young girl with an inguinal

  2. Arteriovenous fistula complicating iliac artery pseudo aneurysm: diagnosis by CT angiography.

    PubMed

    Huawei, L; Bei, D; Huan, Z; Zilai, P; Aorong, T; Kemin, C

    2002-01-01

    Fistula formation to the inferior vena cava is a rare complication of aortic aneurysm which is often misdiagnosed clinically. In one hundred of reported arteriocaval fistulae, none was originating from the right common iliac artery. We report a case of ileo-caval fistula due to a iatrogenic pseudoaneurysm. High resolution 3D imaging using breath-hold CT angiography is highly specific in identifying the location, extent of the aortocaval fistula as well as the neighbouring anatomic structures. PMID:12083621

  3. Unusual manifestation of histoplasmosis in connective tissue diseases

    Microsoft Academic Search

    F. Ceccato; V. Gongora; A. Zunino; S. Roverano; S. Paira

    2007-01-01

    This report describes the coexistence of three patients with rheumatic diseases (systemic lupus erythematosus, rheumatoid\\u000a arthritis, and dermatomyositis) and infections because of Histoplasma capsulatum. Connective tissue diseases and histoplasmosis share several clinical findings. Therefore, histoplasmosis could be misdiagnosed\\u000a as connective tissue disease or a flare of these diseases. Such cases highlight the importance of awareness of histoplasmosis\\u000a in immunocompromised patients,

  4. Profile of Acute Infectious Markers in Sporadic Hepatitis E

    Microsoft Academic Search

    Shoujie Huang; Xuefeng Zhang; Hanmin Jiang; Qiang Yan; Xing Ai; Yijun Wang; Jiaping Cai; Lang Jiang; Ting Wu; Zhongze Wang; Li Guan; J. Wai Kuo Shih; Mun-Hon Ng; Fengcai Zhu; Jun Zhang; Ningshao Xia; Laurent Rénia

    2010-01-01

    Laboratory diagnosis of acute infection of hepatitis E virus (HEV) is commonly based on the detection of HEV RNA, IgM and\\/or rising IgG levels. However, the profile of these markers when the patients present have not been well determined. To clarify the extent of misdiagnosed sporadic hepatitis E in the initial laboratory detection, serial sera of 271 sporadic acute hepatitis

  5. Depression, quality of life and breast cancer: a review of the literature

    Microsoft Academic Search

    M. Reich; A. Lesur; C. Perdrizet-Chevallier

    2008-01-01

    Depression is misdiagnosed and undertreated among breast cancer population. Risk factors for depression in the 5 years after\\u000a diagnosis are related more to the patient rather than to the disease or its treatment. The breast cancer stage (early and\\u000a advanced) is not statistically significant in terms of rates of psychosocial distress except for recurrence. Risk factors\\u000a of depression might impair quality

  6. Metastatic sacrococcygeal yolk sac tumor: A misleading diagnosis

    PubMed Central

    Nsir, Atef Ben; Darmoul, Mehdi; Arous, Sarra Ben; Hattab, Nejib

    2015-01-01

    Sacrococcygeal yolk sac tumor (YST) is an extremely rare malignant extra-gonadal germ-cell tumor, which usually succeeds to the degeneration of more common benign teratoma. We describe here an unprecedented case of conus medullaris compression by a spinal metastasis from a pure sacrococcygeal YST in a 1½ years old girl, which was misdiagnosed initially as an anal fissure and stress the need of a meticulous clinical examination and further screening in young patients presenting with sphincter disturbances.

  7. PERCEPTION OF RACISM IN AMBIGUOUS EVENTS: A CULTURAL PSYCHOLOGY ANALYSIS

    E-print Network

    Salter, Phia Shante

    2008-08-28

    and considered them indicators of pathology (Whaley, 2002; Guthrie, 1976). In fact, clinicians are still likely to misdiagnose Black Americans who express a general mistrust of White society (i.e., cultural paranoia and cultural mistrust) as schizophrenic... or otherwise disturbed (Whaley, 2002; 2006). Although research suggests that cultural mistrust is a normative and adaptive response to a system of racism and oppression (Whaley 2001), these constructions of racism claims as paranoia imply that Black...

  8. The charcot foot: Medical and surgical therapy

    Microsoft Academic Search

    Jan S. Ulbrecht; Dane K. Wukich

    2008-01-01

    Charcot neuro-osteoarthropathy (CN) is among the most devastating complications of neuropathy and now most commonly occurs\\u000a in the feet of diabetic patients. Because it is relatively rare and because most patients and practitioners do not expect\\u000a major bone pathology in the absence of significant pain, CN is often misdiagnosed as cellulitis, deep venous thrombosis, or\\u000a gout. Also, radiographs early in

  9. Pulmonary tuberculosis as differential diagnosis of lung cancer

    PubMed Central

    Bhatt, MLB; Kant, Surya; Bhaskar, Ravi

    2012-01-01

    Patients with lung cancer are often misdiagnosed as pulmonary tuberculosis leading to delay in the correct diagnosis as well as exposure to inappropriate medication. Several factors are responsible for this situation in developing countries, including lack of awareness, inadequate infrastructure and socio-economic factors. This article outlines the differences between the two diseases as well as features that would make a clinician suspect the right diagnosis early. PMID:24455507

  10. Wrist Tenosynovitis due to Mycobacterium bovis Infection: Case Series and Review of the Literature

    PubMed Central

    Güner, Mehmet Dervi?; Bekta?, Umut; Akme?e, Ramazan; Armangil, Mehmet; Ay, ?adan

    2014-01-01

    Summary: Tuberculosis infections are still one of the most important public health problems among developing countries. Musculoskeletal involvement represents 10–15% of all extrapulmonary cases. Tuberculosis tenosynovitis is usually misdiagnosed as nonspecific tenosynovitis. To avoid misdiagnosis and mistreatment, it is important to be alert for mycobacterial infections. This article presents 3 patients with wrist tenosynovitis, which was caused by Mycobacterium bovis infection. The article also includes review of the literature. PMID:25587496

  11. Tips to diagnose uncommon nail disorders.

    PubMed

    Schneider, Samantha L; Tosti, Antonella

    2015-04-01

    This article reviews 6 nail disorders that, although easy to diagnose, are misdiagnosed frequently by dermatologists and general practitioners. Diagnostic clues are emphasized to familiarize readers with features that indicate the correct diagnosis. We focus on two common tumors (onychomatricoma and onychopapilloma), two rare genetic conditions that can be diagnosed owing to nail changes (Darier disease and nail patella syndrome), and two uncommon acquired disorders (the yellow nail syndrome and lichen striatus). PMID:25828712

  12. Acute ECG ST-segment elevation mimicking myocardial infarction in a patient with pulmonary embolism

    PubMed Central

    2010-01-01

    Pulmonary embolism is a common cardiovascular emergency, but it is still often misdiagnosed due to its unspecific clinical symptoms. Elevated troponin concentrations are associated with greater morbidity and mortality in patients with pulmonary embolism. Right ventricular ischemia due to increased right ventricular afterload is believed to be underlying mechanism of elevated troponin values in acute pulmonary embolism, but a paradoxical coronary artery embolism through opened intra-artrial communication is another possible explanation as shown in our case report. PMID:21106090

  13. Mycelial forms of Coccidioides spp. in the parasitic phase associated to pulmonary coccidioidomycosis with type 2 diabetes mellitus

    Microsoft Academic Search

    B. Muñoz-Hernández; G. Palma Cortés; A. Tapia-Díaz; M. E. Manjarrez Zavala

    2008-01-01

    Pulmonary coccidioidomycosis shares characteristics with other pulmonary pathologies. In tissue, spherules containing endospores\\u000a are markers of Coccidioides immitis and C. posadasii infection. Mycelial forms presenting without classical parasitic structures are often misdiagnosed. The study was performed\\u000a at the National Institute of Respiratory Diseases (INER) of Mexico between September 1991 and June 2005 and analyzed the association\\u000a between cases, controls, and

  14. Hair casts

    PubMed Central

    Parmar, Sweta S.; Parmar, Kirti S.; Shah, Bela J.

    2014-01-01

    Hair casts or pseudonits are circumferential concretions, which cover the hair shaft in such a way that, it could be easily removed. They are thin, cylindrical, and elongated in length. We present an unusual case of an 8-year-old girl presenting with hair casts. Occurrence of these is unusual, and they may have varied associations. This patient was suffering from developmental delay. It is commonly misdiagnosed as and very important to differentiate from pediculosis capitis. PMID:25396168

  15. Intracranial extra-axial ependymoma involving the petroclival region: a rare case report

    PubMed Central

    Yang, Xiang; Ren, Yanming; Wu, Weilu; Wang, Xiang; Liu, Xuesong; Zhang, Yuekang

    2014-01-01

    Intracranial extraaxial ependymomas (IEAEs) are very rare, and extra-axial petroclival ependymoma (EAPE) has not been reported in the reviewed English-language literature by now. We present a male patient with EAPE misdiagnosed as a petroclival meningioma preoperatively, and involved recurrence at 4th months after operation though totally resection. Thereafter, we report this case and discuss the clinical characteristics of the disease by briefly review. PMID:25674289

  16. Increased expression of osteopontin gene in atypical teratoid\\/rhabdoid tumor of the central nervous system

    Microsoft Academic Search

    Chung-Lan Kao; Shih-Hwa Chiou; Yann-Jang Chen; Sher Singh; Han-Tso Lin; Ren-Shyan Liu; Chih-Wen Lo; Chi-Chang Yang; Chin-Wen Chi; Chen-hsen Lee; Tai-Tong Wong

    2005-01-01

    The atypical teratoid\\/rhabdoid tumor, primary to the central nervous system, is a highly malignant and aggressive neoplasm of infancy and childhood. Although having distinct biological features and clinical outcomes, it is frequently misdiagnosed as primitive neuroectodermal tumor\\/medulloblastoma. To further distinguish the underlying pathogenesis and to identify biological markers for clinical use, an atypical teratoid\\/rhabdoid tumor-derived cell line was established and

  17. Primary malignant rhabdoid tumor of the cerebellum

    Microsoft Academic Search

    Juan F. Martínez-Lage; Andrés Nieto; Joaquín Sola; Rosario Domingo; Trinidad R. Costa; Máximo Poza

    1997-01-01

    Malignant rhabdoid tumor (MRT) is a recently described variety of childhood renal neoplasm. MRT arising primarily in the\\u000a central nervous system (CNS) is still a rather unfamiliar pathological entity and is frequently misdiagnosed as medulloblastoma\\u000a or primitive neuroectodermal tumor (PNET). We describe a 7-month-old boy who harbored a CNS-MRT that originated within the\\u000a IV ventricle and invaded the brain stem

  18. IgG marker of optic-spinal multiple sclerosis binds to the aquaporin-4 water channel

    Microsoft Academic Search

    Vanda A. Lennon; Thomas J. Kryzer; Sean J. Pittock; A. S. Verkman; Shannon R. Hinson

    2005-01-01

    Neuromyelitis optica (NMO) is an inflammatory demyelinating disease that selectively affects optic nerves and spinal cord. It is considered a severe variant of multiple sclerosis (MS), and frequently is misdiagnosed as MS, but prognosis and optimal treatments differ. A serum immunoglobulin G autoantibody (NMO-IgG) serves as a specific marker for NMO. Here we show that NMO-IgG binds selectively to the

  19. Nasopharyngeal rhabdomyosarcoma mimicking a peritonsillar abscess.

    PubMed

    Steward, Sarah C; Chauvenet, Allen R; O'Suoji, Chibuzo

    2014-01-01

    Rhabdomyosarcoma (RMS) is the most common soft tissue malignancy seen in childhood and frequently occurs in the head and neck region. Pediatric head and neck RMS is often misdiagnosed as common benign conditions. Here we describe an embryonal RMS that presented as a peritonsillar abscess (PTA). Due to an incorrect initial diagnosis and lack of imaging, the patient received unnecessary medical therapy and diagnosis of RMS was delayed. PMID:25643468

  20. Afebrile spotted fever group Rickettsia infection after a bite from a Dermacentor variabilis tick infected with Rickettsia montanensis.

    PubMed

    McQuiston, Jennifer H; Zemtsova, Galina; Perniciaro, Jamie; Hutson, Mark; Singleton, Joseph; Nicholson, William L; Levin, Michael L

    2012-12-01

    Several spotted fever group rickettsiae (SFGR) previously believed to be nonpathogenic are speculated to contribute to infections commonly misdiagnosed as Rocky Mountain spotted fever (RMSF) in the United States, but confirmation is difficult in cases with mild or absent systemic symptoms. We report an afebrile rash illness occurring in a patient 4 days after being bitten by a Rickettsia montanensis-positive Dermacentor variabilis tick. The patient's serological profile was consistent with confirmed SFGR infection. PMID:23153005

  1. [Malignant priapism as a sign of a recurrent prostate cancer. Differential diagnosis of induratio penis plastica].

    PubMed

    Meineke, V; Köhn, F-M; Pickl, U; Ring, J; Vogt, H-J

    2003-06-01

    A 62-year-old patient was referred with the suspected diagnosis of Peyronie disease. The patient showed the clinical picture of a beginning malignant priapism with hematogenous metastases from an recurrent prostatic carcinoma. The penile metastases were misdiagnosed as Peyronie disease. Although both clinical pictures show some superficial similarity, Peyronie disease usually fulfills classical criteria which help to clearly distinguish it from neoplastic diseases. PMID:12759740

  2. Unicentric Castleman’s Disease Presenting as a Pulmonary Mass: A Diagnostic Dilemma

    PubMed Central

    Rawashdeh, Badi; Meyer, Mark; Yimin, Dong; Anthony, Colon; Nguyen, Duy; Moslemi, Mohammad; Golestani, Simin; Richard, Sobonya; Kim, Samuel

    2015-01-01

    Patient: Female, 16 Final Diagnosis: Castleman’s Disease Symptoms: Chest pain • cough non-productive Medication: — Clinical Procedure: — Specialty: Oncology Objective: Rare disease Background: Castleman’s disease, or angiofollicular lymphoid hyperplasia, is a rare disorder and can be easily misdiagnosed as lymphoma, neoplasm, or infection. The diagnosis is challenging due to the nonspecific signs and symptoms as well as the rarity of the disease. We present an unusual case of a young girl presenting with an enlarging pulmonary mass that was believed to be infectious in origin. Case Report: A 16-year-old Native American female from Arizona initially presented with occasional non-productive cough and chest pain. Imaging revealed a 3-cm left upper lobe lobulated mass. This mass was thought to be due to coccidioidomycosis and was treated with fluconazole. Follow-up imaging demonstrated growth of the mass to 4.8 cm. The patient underwent a left video-assisted thoracoscopic left upper lobectomy and mediastinal lymphadenectomy. Histopathological examination revealed Castleman’s disease. Conclusions: Pulmonary masses in young patients can be easily misdiagnosed as infections or cancer. We present the case of a 16-year-old female misdiagnosed as having a fungal infection of the lung, which was later revealed to be Castleman’s disease of the left upper lobe. PMID:25928278

  3. Caution for diagnosis and surgical treatment of recurrent cholangitis: lessons from 5 cases of bile duct tumor thrombus without a detectable intrahepatic tumor.

    PubMed

    Wu, Zheng; Guo, Kun; Sun, Hao; Yu, Liang; Lv, Yi; Wang, Bo

    2014-09-01

    The hepatocellular carcinoma (HCC) patients with bile duct tumor thrombus (BDTT) usually have no specific clinical symptoms at early stages. HCC with BDTT was usually misdiagnosed when the intrahepatic tumor was small, even undetectable. In this study, 5 cases of HCC with BDTT misdiagnosed as choledocholithiasis and cholangitis in the local hospital are described. We analyzed retrospectively and summarized our experiences of these 5 HCC patients with BDTT misdiagnosed in the local hospital during the past 5 years. The diagnosis, treatment, and outcome of the patients are discussed. Three patients underwent hepatectomy with thrombectomy and T-tube drainage. One patient underwent hepatectomy with the resection of the common bile duct and hepatojejunostomy, and palliative surgery was performed in 1 patient with portal vein tumor thrombus and intrahepatic metastasis. The patients were followed for 6-22 months; 4 patients died of tumor recurrence and metastasis or hepatic failure, despite 3 of these patients having received transhepatic arterial chemotherapy and embolization or radiofrequency ablation therapy. Early and accurate diagnosis of HCC with BDTT is very important. When patients have a history of abnormal recurrent cholangitis, HCC with BDTT should be highly suspected. Intraductal ultrasonography (US), intraoperative US, and histopathological examination are very valuable for the diagnosis. The prognosis of HCC patients with BDTT is dismal. Identification of this type of patient is clinically important, because surgical treatment may be beneficial. PMID:25192487

  4. Incidence Patterns and Temporal Trends of Invasive Nonmelanotic Vulvar Tumors in Germany 1999-2011. A Population-Based Cancer Registry Analysis

    PubMed Central

    Buttmann-Schweiger, Nina; Klug, Stefanie J.; Luyten, Alexander; Holleczek, Bernd; Heitz, Florian; du Bois, Andreas; Kraywinkel, Klaus

    2015-01-01

    Objectives Time trends on the incidence and characteristics of invasive vulvar cancer in Germany have so far been studied in few local population- and hospital based tumor registries. We aimed to provide an overview on recent developments of vulvar cancer in Germany, using population-based cancer registry data. Methods We analyzed the data on vulvar cancer of eight population-based German cancer registries for the period 1999-2011. ICD-10 codes and ICD-O-3 morphology codes were used to select site and histologic types. The annual percentage change was calculated on age-adjusted incidence rates with a joinpoint regression model. Results A total of 12,711 registered cases of invasive carcinoma of the vulva were included in the analyses, hereof were 12,205 of squamous cell origin. Age-standardized incidence rates of vulvar cancer annually increased by 6.7% (95% confidence limits: 5.6-7.9) from 1.7 per 100,000 women in 1999 to 3.6 per 100,000 women in 2011. An increase was observed among women of all ages, and especially between 30 and 69 years of age. Conclusion The annual incidence of invasive carcinoma of the vulva nearly doubled in the past decade in Germany, considerably exceeding the rates observed in other Western European countries. A combination of changes in risk factors, and documentation practice might have contributed to the observed substantial increase in vulvar cancer incidence. PMID:26020540

  5. C. elegans Dopaminergic D2-Like Receptors Delimit Recurrent Cholinergic-Mediated Motor Programs during a Goal-Oriented Behavior

    PubMed Central

    Correa, Paola; LeBoeuf, Brigitte; García, L. René

    2012-01-01

    Caenorhabditis elegans male copulation requires coordinated temporal-spatial execution of different motor outputs. During mating, a cloacal circuit consisting of cholinergic sensory-motor neurons and sex muscles maintains the male's position and executes copulatory spicule thrusts at his mate's vulva. However, distinct signaling mechanisms that delimit these behaviors to their proper context are unclear. We found that dopamine (DA) signaling directs copulatory spicule insertion attempts to the hermaphrodite vulva by dampening spurious stimulus-independent sex muscle contractions. From pharmacology and genetic analyses, DA antagonizes stimulatory ACh signaling via the D2-like receptors, DOP-2 and DOP-3, and G?o/i proteins, GOA-1 and GPA-7. Calcium imaging and optogenetics suggest that heightened DA-expressing ray neuron activities coincide with the cholinergic cloacal ganglia function during spicule insertion attempts. D2-like receptor signaling also attenuates the excitability of additional mating circuits to reduce the duration of mating attempts with unproductive and/or inappropriate partners. This suggests that, during wild-type mating, simultaneous DA-ACh signaling modulates the activity threshold of repetitive motor programs, thus confining the behavior to the proper situational context. PMID:23166505

  6. Subunit Principle of Vulvar Reconstruction: Algorithm and Outcomes

    PubMed Central

    Kang, Gavin Chun-Wui; Tay, Eng Hseon; Por, Yong Chen

    2014-01-01

    Background Vulvar defects result chiefly from oncologic resection of vulvar tumors. Reconstruction of vulvar defects restores form and function for the purpose of coitus, micturition, and defecation. Many surgical options exist for vulvar reconstruction. The purpose of this article is to present our experience with vulvar reconstruction. Methods From 2007 to 2013, 43 women presented to us with vulvar defects for reconstruction. Their mean age at the time of reconstruction was 61.1 years. The most common cause of vulvar defect was from resection of vulvar carcinoma and extramammary Paget's disease of the vulva. Method s of reconstruction ranged from primary closure to skin grafting to the use of pedicled flaps. Results The main complications were that of long term hypertrophic and/or unaesthetic scarring of the donor site in 4 patients. Twenty-two patients (51%) were able to resume sexual intercourse. There were no complications of flap loss, wound dehiscence, and urethral stenosis. Conclusions We present a subunit algorithmic approach to vulvar reconstruction based on defect location within the vulva, dimension of the defect, and patient age and comorbidity. The gracilis and gluteal fold flaps are particularly versatile and aesthetically suited for reconstruction of a variety of vulvar defects. From an aesthetic viewpoint the gluteal fold flap was superior because of the well-concealed donor scar. We advocate the routine use of these 2 flaps for vulvar reconstruction. PMID:25075361

  7. Vulvar sarcomas: Short guideline for histopathological recognition and clinical management. Part 2.

    PubMed

    Chokoeva, A A; Tchernev, G; Cardoso, J C; Patterson, J W; Dechev, I; Valkanov, S; Zanardelli, M; Lotti, T; Wollina, U

    2015-06-01

    Malignant tumors of the female reproductive system are a serious health and social problem, as they are the second most common cause of death among women, after breast cancer. Vulvar tumors represent only 4% of all gynecological neoplasms, and they are fourth in frequency after tumors of the cervix, uterus, and ovary. Ninety-eight percent of all vulvar tumors are benign and only 2% are malignant. Sarcomas of the vulva comprise approximately 1-3% of all vulvar cancers. They are characterized by rapid growth, high metastatic potential, frequent recurrences, aggressive behavior, and high mortality rate. In Part 1 of this paper, we presented the most common forms of sarcoma of the vulva: leiomyosarcoma, epithelioid sarcoma, malignant rhabdoid tumor, and rhabdomyosarcoma. The second part of this review will focus mainly on the rarest variants of vulvar sarcoma: low-grade fibromyxoid sarcoma, synovial sarcoma, monophasic synovial sarcoma, carcinosarcoma, Ewing sarcoma, myeloid sarcoma, dermatofibrosarcoma protuberans, malignant fibrous histiocytoma, angiomatoid fibrous histiocytoma, liposarcoma, malignant peripheral nerve sheath tumor, and malignant mesothelioma. PMID:25816393

  8. Vulvar sarcomas: Short guideline for histopathological recognition and clinical management. Part 1.

    PubMed

    Chokoeva, A A; Tchernev, G; Cardoso, J C; Patterson, J W; Dechev, I; Valkanov, S; Zanardelli, M; Lotti, T; Wollina, U

    2015-06-01

    Malignant tumors of the female reproductive system are a serious health and social problem, as they are the second most common cause of death among women, after breast cancer. Their incidence has increased dramatically during recent years, probably due to the different sexual habits and changes in the prevalence of HIV/ AIDS and HPV virus carriers, among other factors. Vulvar tumors represent only 4% of all gynecological neoplasms, and they are fourth in frequency after tumors of the cervix, uterus, and ovary. Ninety eight percent of all vulvar tumors are benign and only 2% are malignant. The overall incidence of tumors with vulvar location is between two and seven cases per 100,000 women, and it increases with age, while the death rate is estimated at 0.7 per 100,000 women. Sarcomas of the vulva comprise approximately 1-3% of all vulvar cancers, with leiomyosarcomas, epithelioid sarcomas, and rhabdomyosarcomas being the most common among them. They are characterized by rapid growth, high metastatic potential, frequent recurrences, aggressive behavior, and high mortality rate. In this paper, we present the most common forms of sarcomas of the vulva (leiomyosarcoma, epithelioid sarcoma, malignant rhabdoid tumor, rhabdomyosarcoma) in order to emphasize the broad differential diagnosis, rare appearance, non-specific clinical picture, aggressive course, and high mortality. PMID:25816394

  9. Calcaridorylaimus castaneae sp. n. (Nematoda, Dorylaimidae) from Bulgaria with an identification key to the species of the genus

    PubMed Central

    Nedelchev, Sevdan; Elshishka, Milka; Lazarova, Stela; Radoslavov, Georgi; Hristov, Peter; Peneva, Vlada

    2014-01-01

    Abstract An unknown species belonging to the genusCalcaridorylaimus Andrássy, 1986 was collected from the litter of broadleaf forests dominated by Castanea sativa Mill. and mixed with Quercus daleshampii Ten. and Fagus sylvatica L. on Belasitsa Mountain, south-western Bulgaria. Calcaridorylaimus castaneae sp. n. is characterised by its long body (1.4–2.1 mm), lip region practically not offset, vulva transverse, short odontostyle (14.5–16 ?m) and tail (75.5–110.5 ?m, c=14.7–23.6; c’=2.9–4.4) in females and 38–46 ?m long spicules with small spur before their distant end in males. It is most similar to C. andrassyi Ahmad & Shaheen, 2004, but differs in having transverse vs pore-like vulva and shorter spicules (38–46 ?m vs 52–57 ?m). An identification key to the species of the genus Calcaridorylaimus is proposed. Phylogenetic analyses were performed on 18S and D2-D3 expansion domains of 28S rRNA genes by Neighbor-Joining, Maximum Likelihood and Bayesian Inference methods. The phylograms inferred from 18S sequences showed closest relationships of the new species with some species belonging to the genus Mesodorylaimus. However, insufficient molecular data for members of both genera do not allow the phylogenetic relationships of Calcaridorylaimus and the new species described herein to be elucidated. PMID:24899849

  10. Changes in Men’s Salivary Testosterone and Cortisol Levels, and in Sexual Desire after Smelling Female Axillary and Vulvar Scents

    PubMed Central

    Cerda-Molina, Ana Lilia; Hernández-López, Leonor; de la O, Claudio E.; Chavira-Ramírez, Roberto; Mondragón-Ceballos, Ricardo

    2013-01-01

    Several studies have shown that a woman’s vaginal or axillary odors convey information on her attractivity. Yet, whether such scents induce psychoneuroendocrinological changes in perceivers is still controversial. We studied if smelling axillary and vulvar odors collected in the periovulatory and late luteal phases of young women modify salivary testosterone and cortisol levels, as well as sexual desire in men. Forty-five women and 115 men, all of them college students and unacquainted with each other, participated in the study. Female odors were collected on pads affixed to the axilla and on panty protectors both worn the entire night before experiments. Men provided five saliva samples, a basal one before the smelling procedure, and four more 15, 30, 60, and 75?min after exposure to odors. Immediately after smelling the odor source, men answered a questionnaire rating hedonic qualities of scents, and after providing the last saliva sample they answered questionnaire on sexual desire. We found that periovulatory axillary and vulvar odors increased testosterone and cortisol levels, with vulvar scents producing a more prolonged effect. Luteal axilla odors decreased testosterone and cortisol levels, while luteal vulva odors increased cortisol. Periovulatory axilla and vulva scents accounted for a general increase of interest in sex. These odors were also rated as more pleasant and familiar, while luteal vulvar odors were perceived as intense and unpleasant. PMID:24194730

  11. Cryphodera sinensis n. sp. (Nematoda: Heteroderidae), a non-cyst-forming parasitic nematode from the root of ramie Boehmeria nivea in China.

    PubMed

    Zhuo, K; Wang, H H; Ye, W; Peng, D L; Liao, J L

    2014-12-01

    Cryphodera sinensis n. sp. is described from ramie (Boehmeria nivea) based on the morphology and molecular analyses of rRNA small subunit (SSU), D2D3 expansion domains of large subunit (LSU D2D3) and internal transcribed spacer (ITS). This new species is characterized by oval females with a distinct subcrystalline layer and pronounced and protruding vulval lip, distinctly concave vulva-anus profile and a vulva-anus distance of 29.5-35.8 ?m. Males possess two annuli in the lip region, a stylet 27-32.5 ?m in length with round knobs sloping slightly posteriorly, lateral fields with three lines, spicules 20-28 ?m long and the presence of a short cloacal tube. Second-stage juveniles possess three lip annuli, a stylet 28-31 ?m in length with well-developed knobs projected anteriorly and three lines along the lateral field. The pointed tail, 52-65 ?m long, possesses a mucro-like tip and a hyaline region, 24.5-35 ?m long. Large phasmids with a lens-like structure are located 2-6 annuli posterior to the anus. Phylogenetic analysis shows that the species has unique SSU, LSU D2D3 and ITS rRNA sequences. Phylogenetic relationships of the three rDNA sequences of C. sinensis n. sp. and other cystoid/cyst nematodes are analysed together with a comparison of other species within the genus Cryphodera. PMID:23782683

  12. Human Infections with Spirometra decipiens Plerocercoids Identified by Morphologic and Genetic Analyses in Korea

    PubMed Central

    Jeon, Hyeong-Kyu; Park, Hansol; Lee, Dongmin; Choe, Seongjun; Kim, Kyu-Heon; Huh, Sun; Sohn, Woon-Mok; Chai, Jong-Yil; Eom, Keeseon S.

    2015-01-01

    Tapeworms of the genus Spirometra are pseudophyllidean cestodes endemic in Korea. At present, it is unclear which Spirometra species are responsible for causing human infections, and little information is available on the epidemiological profiles of Spirometra species infecting humans in Korea. Between 1979 and 2009, a total of 50 spargana from human patients and 2 adult specimens obtained from experimentally infected carnivorous animals were analyzed according to genetic and taxonomic criteria and classified as Spirometra erinaceieuropaei or Spirometra decipiens depending on the morphology. Morphologically, S. erinaceieuropaei and S. decipiens are different in that the spirally coiled uterus in S. erinaceieuropaei has 5-7 complete coils, while in S. decipiens it has only 4.5 coils. In addition, there is a 9.3% (146/1,566) sequence different between S. erinaceieuropaei and S. decipiens in the cox1 gene. Partial cox1 sequences (390 bp) from 35 Korean isolates showed 99.4% (388/390) similarity with the reference sequence of S. erinaceieuropaei from Korea (G1724; GenBank KJ599680) and an additional 15 Korean isolates revealed 99.2% (387/390) similarity with the reference sequences of S. decipiens from Korea (G1657; GenBank KJ599679). Based on morphologic and molecular databases, the estimated population ratio of S. erinaceieuropaei to S. decipiens was 35: 15. Our results indicate that both S. erinaceieuropaei and S. decipiens found in Korea infect humans, with S. erinaceieuropaei being 2 times more prevalent than S. decipiens. This study is the first to report human sparganosis caused by S. decipiens in humans in Korea. PMID:26174823

  13. Differential Diagnosis of Jakob-Creutzfeldt Disease

    PubMed Central

    Paterson, Ross W.; Torres-Chae, Charles C.; Kuo, Amy L.; Ando, Tim; Nguyen, Elizabeth A.; Wong, Katherine; DeArmond, Stephen J.; Haman, Aissa; Garcia, Paul; Johnson, David Y.; Miller, Bruce L.; Geschwind, Michael D.

    2015-01-01

    Objectives To identify the misdiagnoses of patients with sporadic Jakob-Creutzfeldt disease (sCJD) during the course of their disease and determine which medical specialties saw patients with sCJD prior to the correct diagnosis being made and at what point in the disease course a correct diagnosis was made. Design Retrospective medical record review. Setting A specialty referral center of a tertiary academic medical center. Participants One hundred sixty-three serial patients over a 5.5-year period who ultimately had pathologically proven sCJD. The study used the subset of 97 patients for whom we had adequate medical records. Main Outcome Measures Other diagnoses considered in the differential diagnosis and types of medical specialties assessing patients with sCJD. Results Ninety-seven subjects’ records were used in the final analysis. The most common disease categories of misdiagnosis were neurodegenerative, autoimmune/paraneoplastic, infectious, and toxic/metabolic disorders. The most common individual misdiagnoses were viral encephalitis, paraneoplastic disorder, depression, vertigo, Alzheimer disease, stroke, unspecified dementia, central nervous system vasculitis, peripheral neuropathy, and Hashimoto encephalopathy. The physicians who most commonly made these misdiagnoses were primary care physicians and neurologists; in the 18% of patients who were diagnosed correctly at their first assessment, the diagnosis was almost always by a neurologist. The mean time from onset to diagnosis was 7.9 months, an average of two-thirds of the way through their disease course. Conclusions Diagnosis of sCJD is quite delayed. When evaluating patients with rapidly progressive dementia with suspected neurodegenerative, autoimmune, infectious, or toxic/metabolic etiology, sCJD should also be included in the differential diagnosis, and appropriate diagnostic tests, such as diffusion brain magnetic resonance imaging, should be considered. Primary care physicians and neurologists need improved training in sCJD diagnosis. PMID:23229042

  14. Benign infantile convulsion as a diagnostic clue of paroxysmal kinesigenic dyskinesia: a case series

    PubMed Central

    2014-01-01

    Introduction Paroxysmal kinesigenic dyskinesia is characterized by sudden attacks of involuntary movements. It is often misdiagnosed clinically as psychogenic illness, which distresses the patients to a great extent. A correct diagnosis will improve the quality of life in patients with paroxysmal kinesigenic dyskinesia because treatment with low doses of anticonvulsants is effective for eliminating the clinical manifestations. Paroxysmal kinesigenic dyskinesia can occur independently of or concurrently with benign infantile convulsion. Identification of PRRT2 as the causative gene of benign infantile convulsion and paroxysmal kinesigenic dyskinesia allows genetic confirmation of the clinical diagnosis. Case presentation We describe the clinical features of a Japanese family with either paroxysmal kinesigenic dyskinesia or benign infantile convulsion. A PRRT2 missense mutation (c.981C?>?G, p.Ile327Met) was identified in two patients with benign infantile convulsion and three patients with paroxysmal kinesigenic dyskinesia as well as in two unaffected individuals. Allowing incomplete penetrance in the mutation carriers, this mutation co-segregated completely with the phenotype. The patients with paroxysmal kinesigenic dyskinesia had been misdiagnosed with psychogenic illness for many years. They were correctly diagnosed with paroxysmal kinesigenic dyskinesia when their children visited a pediatrician for benign infantile convulsion. Treatment with carbamazepine controlled their involuntary movements completely. Conclusions Paroxysmal kinesigenic dyskinesia is a treatable movement disorder that is often misdiagnosed clinically as psychogenic illness. It is important to note that two clinically distinct disorders, benign infantile convulsion and paroxysmal kinesigenic dyskinesia, are allelic conditions caused by PRRT2 mutations. Paroxysmal kinesigenic dyskinesia should be suspected in families with a child with benign infantile convulsion. PMID:24886244

  15. Tinea atypica: report of nine cases.

    PubMed

    Zisova, Liliya Georgieva; Dobrev, Hristo Petrov; Tchernev, Georgi; Semkova, Kristina; Aliman, Anastasia Atanasova; Chorleva, Kristina Ivanova; Chapanova, Antonina Teneva; Vutova, Nina Ivanova; Wollina, Uwe

    2013-12-01

    Fungal infections of the skin are a common condition, usually easy to diagnose and treat. When the infection is clinically mimicking another cutaneous disorder or when the clinical presentation is modified by the use of inappropriate treatment, it is referred to as tinea atypica or tinea incognito.We report a series of nine cases of patients with tinea atypica, imitating and diagnosed initially as different skin diseases. Two patients were defined as pyoderma in the facial and pubic regions (caused respectively by Trichophyton mentagrophytes var. mentagrophytes and Microsporum canis) and one as herpes zoster ophthalmicus (caused by Trichophyton rubrum). Six additional patients were initially misdiagnosed: (1) Plaque-like formation of the skin misdiagnosed as an impetiginized eczema (with isolated agent Trichophyton verrucosum). (2) A rare form of skin infection of the hand caused by T. rubrum, imitating clinically cutaneous infection with tuberculum mulgentium. (3) Rosacea-like dermatitis with an isolated agent Fusarium. (4) A patient with the typical clinical symptoms of seborrheic dermatitis of the face (and with isolated T. rubrum as a causative agent). (5) Another patient presented with a widespread folliculitis by Trichophyton mentagrophytes. (6) In a patient with bullous pemphigoid and immunosuppression pemphigoid-like eruptions were caused by Malassezia pachydermatis and T. rubrum. The diagnosis in the presented cases was based on direct microscopic examination with KOH and a culture on Sabouraud agar.After the diagnosis of tinea, treatment with topical and systemic antifungal agents was administrated, followed by complete clinical remissions in all cases.The clinical manifestations of tinea atypica can mimic a large number of other dermatoses, which often leads to misdiagnosing, and as a consequence--to serious difficulties in the management of clinical symptoms and in offering appropriate therapy. PMID:23949566

  16. Danazol: an effective option in acquired amegakaryocytic thrombocytopaenic purpura.

    PubMed

    Mulroy, E; Gleeson, S; Chiruka, S

    2015-01-01

    Acquired amegakaryocytic thrombocytopaenic purpura (AATP) is a rare haematological condition characterised by isolated thrombocytopaenia with normal other cell lines. It is often initially misdiagnosed as immune thrombocytopaenic purpura but has characteristic bone marrow findings of reduced megakaryocyte numbers. The optimal treatment of AATP is not clearly defined but revolves around immunosuppressive therapies. We report a case of successful treatment of AATP with danazol, an antioestrogenic medication. We also review the aetiologies and pathogenesis of the disorder and suggest that danazol should be considered as an effective alternative to potent immunosuppression in AATP. PMID:25945269

  17. Crowned dens syndrome diagnosed on ¹?F-FDG PET/CT.

    PubMed

    Monet, Antoine; Massonnat, Richard; Merino, Bertrand; Riviere, Annalisa; Richez, Christophe

    2014-12-01

    An 87-year-old woman with corticosteroid-resistant polymyalgia rheumatica underwent ¹?F-FDG PET/CT for suspected giant cell arteritis or neoplastic disease. FDG uptake in the immediate vicinity of the odontoid process, with a crownlike calcification, was identified on the CT scan on the posterior side of the dens, thus confirming the diagnosis of crowned dens syndrome. Because this rare syndrome is frequently misdiagnosed, nuclear physicians should be aware of the signs and symptoms of this condition, which may call for the use of PET/CT imagery. PMID:25243939

  18. Crowned Dens Syndrome: A Case Report and Review of the Literature

    PubMed Central

    Lee, Gwang Soo; Park, Hyung Ki; Chang, Jae Chil

    2014-01-01

    The crowned dens syndrome (CDS), also known as periodontoid calcium pyrophosphate dehydrate crystal deposition disease, is typified clinically by severe cervical pain, neck stiffness and atlantoaxial synovial calcification which could be misdiagnosed as meningitis, epidural abscess, polymyalgia rheumatica, giant cell arthritis, rheumatoid arthritis, cervical spondylitis or metastatic spinal tumor. Crystalline deposition on cervical vertebrae is less well known disease entity and only a limited number of cases have been reported to date. Authors report a case of CDS and describe the clinical feature. PMID:24891867

  19. Preparedness of health care practitioners to screen women for domestic violence in a border community.

    PubMed

    Goff, Heather W; Shelton, A J; Byrd, Theresa L; Parcel, Guy S

    2003-02-01

    Health care professionals do not always screen patients for domestic abuse. In the absence of screening, the likelihood of misdiagnoses and prescriptions contraindicated for symptoms of abuse survivors is increased. Several factors may contribute to the lack of routine and uniform screening, including a lack of educational preparedness. The qualitative findings presented here are part of a larger quantitative study investigating the skills, beliefs, and expectations about screening for domestic abuse among physicians, dentists, and nurse practitioners from a border community in southwest Texas. Practitioners requested specific information to enhance educational preparedness and improve clinical practice for their abused patients. PMID:12746023

  20. Spindle cell amelanotic lesion of the tongue: a diagnostic and therapeutic challenge.

    PubMed

    Kumar, Vinay; Shukla, Mridula; Goud, Umakanth; Ravi, Devendra Kumar; Kumar, Mohan; Pandey, Manoj

    2013-06-01

    Melanomas occurring in the tongue are rarer, and when nonpigmented they are often misdiagnosed as squamous cell carcinoma. We report a 50-year-old woman who presented with a 3?×?2 cm soft swelling of mucosal color on the right lateral border of the tongue. The patient had multiple recurrences and was treated by radical radiotherapy, was operated thrice and received adjuvant 5 MIU interferon weekly. During the last surgery, she developed multiple cerebral infarcts and died on the fifth postoperative day. Oral amelanotic melanoma is a very aggressive and potential lethal tumor that often presents as diagnostic dilemma. PMID:24426627

  1. Pressure bandage over venous conduit harvesting site causing compartment syndrome in a patient with intra-aortic balloon pump: An unusual cause.

    PubMed

    Rastogi, Amit; Haldar, Rudrashish; Majumdar, Gauranga; Pahade, Akhilesh; Singh, Prabhat K

    2015-01-01

    Intra Aortic Balloon Pump (IABP) is conventionally used to support coronary perfusion and weaning from cardiopulmonary bypass. IABP in situ has its own share of complications. We present a case where a patient on IABP support who had reduced peripheral pulsations of the ipsilateral limb and was initially misdiagnosed as IABP catheter associated thromboembolism. A negative embolectomy ruled out the same. Further looking for the cause of reduction of ipsilateral pulses it was found that the tight compressive bandage at saphenous vein conduit harvesting site had led to development of compartment syndrome (CS). PMID:26139763

  2. Primary Adrenal Insufficiency Caused by a Novel Mutation in DAX1 Gene

    PubMed Central

    Evliyao?lu, Olcay; Dokurel, ?pek; Bucak, Feride; Özcab?, Bahar; Ercan, Oya; Ceylaner, Serdar

    2013-01-01

    Adrenal hypoplasia congenita (AHC) is a rare disorder. The X-linked form is related to mutations in the DAX1 (NROB1) gene. Here, we report a newborn who had a novel hemizygous frameshift mutation in DAX1 (c.543delA) and presented with primary adrenal failure that was initially misdiagnosed as congenital adrenal hyperplasia. This report highlights the value of genetic testing for definite diagnosis in children with primary adrenal failure due to abnormal adrenal gland development, providing the possibility both for presymptomatic, and in cases with a sibling with this condition, for prenatal diagnosis. Conflict of interest:None declared. PMID:23367499

  3. Hypothyroidism simulating as polymyositis.

    PubMed

    Aslam, Hina; Sayeed, Mohammad Ahsan; Qadeer, Rashid; Afsar, Salahuddin

    2015-05-01

    Polymyositis-like syndrome in hypothyroidism is a rare condition characterised by proximal muscle weakness and elevated muscle enzymes. Patients with this condition can initially be misdiagnosed as having polymyositis due to similar characteristics of both diseases; however a response to thyroxine is the main differentiating feature. This report highlights the case of a 30-year-old male who had severe myalgia and proximal muscle weakness. In addition to raised creatinine phosphokinase (CPK) levels, his biochemical profile showed hypothyroidism. Initially thought to be suffering from polymyositis, improvement in both clinical and biochemical profile with thyroxine led to the diagnosis of polymyositis-like syndrome associated with hypothyroidism. PMID:26028394

  4. Spiders and Other Arachnids at UC Riverside

    NSDL National Science Digital Library

    Rick Vetter

    This page provides information on venomous spiders and other stinging or biting arthropods, especially the brown recluse spider. Topics include the distribution and misidentification of the brown recluse, misdiagnoses of brown recluse bites, how to identify this species, and popular myths surrounding it. There is also information on daddy-longlegs (Opiliones)and daddy-longlegs spiders (Pholcidae), hobo spiders (Tegenaria agrestis), internet hoaxes involving spiders, and an article on bites and stings of medically important venomous arthropods (bees, wasps, ants, spiders, and scorpions).

  5. Stiff Man Syndrome: A Diagnostic Dilemma in a Young Female with Diabetes Mellitus and Thyroiditis

    PubMed Central

    Enuh, Hilary; Park, Michael; Ghodasara, Arjun; Arsura, Edward; Nfonoyim, Jay

    2014-01-01

    Stiff Person Syndrome (SPS), is a very rare neuroimmunologic disorder characterized by progressive muscle pain, rigidity, stiffness, and spasms. It can be very debilitating if misdiagnosed or not recognized in time. Herein we discuss a case of a female in her 20s who presented with an unsteady gait, lower extremity weakness, persistent leg pain, and stiffness few weeks after uncomplicated childbirth. She has type 1 diabetes mellitus (DM) and was diagnosed with thyroiditis in the course of her illness. The triad of thyroiditis, DM, and stiffness with normal neuroimaging in a young female patient is an unusual occurrence. PMID:25525403

  6. Maslow's Hierarchy of Needs and the individual with chronic vestibular dysfunction.

    PubMed

    Haybach, P J

    1994-01-01

    Individuals with chronic vestibular dysfunction may have unmet physiological or safety needs on a chronic basis. Their inability to fulfill the basic needs and progress to higher needs can lead to a patient population with many psychosocial problems. Very often such problems are ignored or unrecognized or are misdiagnosed, and treated inappropriately. This disruption in the individual's life can lead to an inability to progress as a human being. Nursing assessment and appropriate interventions should be developed to treat psychosocial problems in this patient population. The nursing profession should serve patients with vestibular dysfunction through direct care, teaching, counseling, support group facilitation, and research into appropriate interventions. PMID:8564758

  7. Pseudoaneurysm of the internal maxillary artery following mandibular condylar fracture

    PubMed Central

    Katakol, Basavaraj; Govindaraj, E.

    2014-01-01

    Pseudoaneurysm of the internal maxillary artery is a rare occurrence. A well-organized pulsatile mass that develops after a traumatic event indicates a pseudoaneurysm. Such lesions are commonly misdiagnosed for an abscess or a hematoma. Pulsations and audible bruit are diagnostic features of an aneurysm. Rupture of such false aneurysms cause significant morbidity. Management is either surgical resection or embolization. Endovascular embolization is indicated in deep seated lesions or lesions with high morbidity. Though surgical resection is an invasive procedure, it is considered to be an alternative to embolization. PMID:25593875

  8. Large cell neuroendocrine carcinoma of the uterine cervix: a report of a case and review of the literature

    Microsoft Academic Search

    Yilmaz Dikmen; Mert Kazandi; Osman Zekioglu; Aydin Ozsaran; Mustafa Cosan Terek; Yildiz Erhan

    2004-01-01

    Introduction  Large cell neuroendocrine carcinoma is a rare aggressive cervical neoplasm, considerably rarer than the well-recognized small\\u000a cell neuroendocrine carcinoma of the cervix. Cervical large cell neuroendocrine carcinomas are distinctive cervical carcinomas\\u000a that are frequently misdiagnosed and have an unfavorable outcome, similar to that of small cell carcinoma.\\u000a \\u000a \\u000a \\u000a Case report  We report a 45-year-old woman with large cell neuroendocrine uterine cervical carcinoma.

  9. Axillary Schwannoma with Extensive Cystic Degeneration

    PubMed Central

    Jadhav, Chaithra R; Angeline, N R; Kumar, Bipin; Bhat, Ramachandra V; Balachandran, G

    2013-01-01

    Schwannoma affect mainly head, neck, and flexor aspect of the limbs. Neurogenic tumors arising from the brachial plexus are rare and axillary schwannoma is extremely uncommon. Cystic degeneration is common in longstanding cases and which when aspirated may yield only macrophages or lymphocytes leading to false diagnosis of the case in spite of strong clinical suspicion. We report one such rare case of a solitary axillary schwannoma with extensive cystic degeneration, which was misdiagnosed on fine needle aspiration cytology and subsequently confirmed by the histopathological examination and immunohistochemistry. PMID:24014973

  10. Intrathoracic ancient neurilemoma mimicking mesenchymal thoracic tumor.

    PubMed

    Chen, Yu-Hung; Hsu, Yung-Hsiang; Chang, Huai-Ren

    2013-11-01

    Ancient neurilemoma is a rare variant of neurilemoma and can grow into a large tumor, which results in several symptoms. It is often misdiagnosed to be malignant neoplasm because of its histological features of nuclear atypia. The authors reported an 87-year-old woman presenting with progressive dyspnea and chronic cough for more than 1 year. Computed tomography of the chest showed a huge heterogeneous, paravertebral mass with focal calcification, arising from intervertebral foramen. The tumor was successfully resected by thoracotomy and pathology disclosed ancient neurilemoma. PMID:23694925

  11. Imaging appearance of petrous apex dermoid cysts containing little or no fat.

    PubMed

    Ageshio, Naomi; Shimono, Taro; Goto, Takeo; Ohata, Kenji; Ohsawa, Masahiko; Wakasa, Kenichi; Miki, Yukio

    2013-02-01

    Intracranial dermoid cysts are rare congenital lesions with typical imaging findings of well-defined fat-containing masses located along the midline and infratentorial regions. We report two rare cases of petrous apex dermoid cyst, one in the petrous apex and the other in the interdural space, with unusual imaging appearances mimicking epidermoid cysts because of the presence of little or no fat. Dermoid cysts with little or no lipid contents, as in these cases, may be radiologically misdiagnosed as epidermoid cysts. Careful evaluation of preoperative computed tomography and magnetic resonance images is necessary because the surgical approaches used for this region vary depending on the accurate location and histopathology. PMID:23070582

  12. Lateral sided snapping elbow caused by a meniscus: two case reports and literature review.

    PubMed

    Kang, Shin-Taek; Kim, Tae-Ho

    2010-06-01

    Lateral sided snapping elbow is an unusual condition, and it is apt to be misdiagnosed as lateral epicondylitis. The causes of lateral sided snapping elbow have been attributed to intraarticular loose bodies, instability, synovial plicae and torn annular ligament. We report our experiences for treating lateral sided snapping elbow caused by a meniscus in the radio-humeral joint. In the present cases, the cause of snapping was detected using double contrast arthrogram under fluoroscopic control, and histology revealed that it was a meniscus. Complete removal of the meniscus allowed immediate relief of the symptom, and there was no recurrence in both cases. PMID:20151108

  13. Misdiagnosis of Abdominal Pain in Pregnancy: Acute Pancreatitis

    PubMed Central

    Samal, Sunita; Gupta, Shweta; Begum, Jasmina; Ghose, Seetesh

    2015-01-01

    We report a case of acute pancreatitis in a pregnant woman who presented to our emergency department with complaints of severe abdominal pain, was misdiagnosed as scar dehiscence and underwent emergency repeat caesarean section at 33 wks for fetal distress. The preterm baby developed severe respiratory distress and succumbed on the second postnatal day. Persistent severe pain in the postoperative period in the mother prompted further evaluation which led to a diagnosis of acute pancreatitis. Conservative and supportive management was instituted leading to an eventual favourable maternal outcome. PMID:25738042

  14. Frontotemporal dementia mimicking bipolar disorder.

    PubMed

    Kerstein, Andrew H; Schroeder, Ryan W; Baade, Lyle E; Lincoln, Janka; Khan, Ahsan Y

    2013-11-01

    Frontotemporal dementia is a cause of behavioral disturbance that usually appears in individuals between 45 and 65 years of age. The authors present the case of a 65-year-old patient that illustrates how frontotemporal dementia can be misdiagnosed based on a behavioral pattern that suggests the presence of a primary mood disorder. Early accurate diagnosis of frontotemporal dementia and subsequent supportive measures can allow patients and families to make important decisions about business and legal affairs and how to spend remaining leisure time in the most meaningful and enjoyable way possible. PMID:24241504

  15. PRKAG2 mutation: An easily missed cardiac specific non-lysosomal glycogenosis

    PubMed Central

    Aggarwal, Varun; Dobrolet, Nancy; Fishberger, Steven; Zablah, Jenny; Jayakar, Parul; Ammous, Zineb

    2015-01-01

    Mutations in PRKAG2 gene that regulates the ?2 subunit of the adenosine monophosphate (AMP) dependent protein kinase have been associated with the development of atrioventricular (AV) accessory pathways, cardiac hypertrophy, and conduction system abnormalities. These patients can potentially be misdiagnosed as hypertrophic cardiomyopathy (HOCM) and/or Wolf-Parkinson White (WPW) syndrome due to similar clinical phenotype. Early recognition of this disease entity is very important as ablation of suspected accessory pathways is not effective and the natural history of the disease is very different from HOCM and WPW syndrome. PMID:26085771

  16. Subhallucal Interphalangeal Sesamoiditis: A Rare Cause of Chronic Great Toe Pain

    PubMed Central

    Kadavigere, Rajagopal; Puppala, Radha; Ayachit, Anurag; Singh, Ruchika

    2015-01-01

    Subhallucal interphalangeal sesamoiditis presenting as chronic great toe pain is a rarely reported clinical entity, being often overlooked and misdiagnosed for other pathologies. By altering the biomechanics of the movements at great toe, the interphalangeal sesamoid is prone to various painful pathologies like trauma, infection, degeneration, osteonecrosis and inflammation. Imaging plays an important role in narrowing down the differentials and guiding for appropriate therapy. Herein, we present a neglected case of hallucal interphalangeal sesamoiditis presenting as a case of chronic great toe pain and discuss the role of Magnetic resonance imaging (MRI) and Computed tomography (CT) scan in its diagnosis.

  17. Pulmonary capillary haemangiomatosis: a rare cause of pulmonary hypertension.

    PubMed

    Babu, K Anand; Supraja, K; Singh, Raj B

    2014-01-01

    Pulmonary capillary haemangiomatosis (PCH) is a rare disorder of unknown aetiology, characterised by proliferating capillaries that invade the pulmonary interstitium, alveolar septae and the pulmonary vasculature. It is often mis-diagnosed as primary pulmonary hypertension and pulmonary veno-occlusive disease. Pulmonary capillary haemangiomatosis is a locally aggressive benign vascular neoplasm of the lung. We report the case of a 19-year-old female who was referred to us in the early post-partum period with severe pulmonary artery hypertension, which was diagnosed as PCH by open lung biopsy. PMID:25962202

  18. Pulmonary arteriovenous malformations presenting as refractory heart failure

    PubMed Central

    Chen, Kai-Hong; Huang, Guo-Yong; Song, Wei

    2014-01-01

    A 22-year-old young man with a history of idiopathic dilated cardiomyopathy (IDC) was admitted to our hospital due to difficult-to-control heart failure. A thoracic X-ray showed multiple nodules at the both pulmonary hilus and upper lobe of the right lung. Computed tomography (CT) angiography of the thorax confirmed arteriovenous malformation (AVM). However, effective treatment was impossible due to the poor physical condition; he died a few days later. Here we reported on the case of pulmonary arteriovenous malformations (PAVMs) being misdiagnosed as refractory heart failure. PMID:25276390

  19. Aortic dissection presenting as acute myocardial infarction: potential harm of antithrombin and antiplatelet therapy

    PubMed Central

    Gu, Y.L.; van den Heuvel, A.F.M.; Erasmus, M.E.; Zijlstra, F.

    2006-01-01

    In the treatment of acute myocardial infarction, antithrombin and antiplatelet therapy are indicated according to the current guidelines. When a patient presents with symptoms and signs of acute myocardial infarction, an extensive list of diagnoses should be considered. Because of the nonspecific symptoms of aortic dissection, the disease may be easily misdiagnosed. A high clinical suspicion of aortic dissection is therefore required. Once aortic dissection has been diagnosed, surgical intervention provides the only definitive treatment for these patients, regardless of antithrombin and antiplatelet therapy. ImagesFigure 1Figure 2 PMID:25696613

  20. Managing Attention Deficit Hyperactivity Disorder in the Emergency Department

    PubMed Central

    Klykylo, Katherine T.; Klykylo, William M.

    2008-01-01

    ADHD, often misdiagnosed or unrecognized, can lead to serious personal and family disruption. Younger patients with ADHD frequently present to hospital emergency departments with crises involving behavioral dyscontrol, legal, school or family conflict, and substance abuse. An emergency room visit provides an excellent opportunity to use such crises as catalysts to effect lasting change in these patients and their families. The efficacy of a biopsychosocial model is demonstrated in a case involving a 15-year-old boy presenting to the emergency department with legal, psychological, educational, and family problems. Multiple teaching points are highlighted throughout the case. PMID:19727275

  1. Sacrococcygeal teratoma with nephroblastic elements: a case report and review of literature

    PubMed Central

    Ma, Yangyang; Zheng, Jicui; Zhu, Haitao; Shen, Chun; Zheng, Shan; Xiao, Xianmin; Chen, Lian

    2014-01-01

    Sacrococcygeal teratoma with nephroblastic elements is very rare. Only 8 cases have been reported up to date. 3 cases were misdiagnosed as extrarenal nephroblastomas and were administered excessive treatments such as chemotherapy and radiation therapy. It has a great significance to distinguish sacrococcygeal teratoma with nephroblastic elements from extrarenal nephroblastoma for their different biological behaviors, therapies and prognoses. Here we report one case of sacrococcygeal teratoma with nephroblastic elements in a newborn with review of the literature. This is the first case of sacrococcygeal teratoma with nephroblastic elements in Chinese to our knowledge. PMID:25550874

  2. Pilomatrix carcinoma of the eyebrow.

    PubMed

    Pauly, Marian; Subramanian, Krishnakumar; Anantharaman, Giridhar; Anthony, Eliza

    2015-01-01

    Pilomatrix carcinoma is an uncommon malignant neoplasm originating from the hair follicle matrix. It occurs more frequently in head and neck region and rarely on the eyelid and eyebrow. It is often clinically misdiagnosed. The diagnosis is confirmed by excision biopsy and histopathological examination. A 68-year-old woman presented with a mass on her left eyebrow mimicking sebaceous cyst. An excisional biopsy with 4-mm margin was performed under frozen section. Histopathology demonstrated pilomatrix carcinoma with cystic degeneration. Periocular malignancies can have unusual origins with specific clinical features. Preoperative clinical examination is mandatory to rule out unusual features and thereby ensure appropriate management to prevent serious complications. PMID:24833440

  3. Group A streptococcal vaginitis: an unrecognized cause of vaginal symptoms in adult women

    Microsoft Academic Search

    Hans Verstraelen; Rita Verhelst; Mario Vaneechoutte; Marleen Temmerman

    2011-01-01

    Purpose  Vaginal infection with group A streptococci (GAS) is an established cause of vaginitis amongst prepubescent girls, but largely\\u000a unrecognized in adult women and therefore often misdiagnosed as vulvovaginal candidosis. We sought to give an overview of\\u000a the epidemiology, risk factors, symptoms, signs, and treatment of GAS vaginitis in adult women.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Systematic literature search.\\u000a \\u000a \\u000a \\u000a Results  We identified nine case reports covering 12

  4. A case of negative pressure pulmonary edema in an asthmatic patient after laparoscopic cholecystectomy

    PubMed Central

    Rasheed, Asim; Palaria, Urmila; Rani, Dolly; Sharma, Shatrunjay

    2014-01-01

    Negative pressure pulmonary edema is often misdiagnosed or can go clinically unrecognized by anesthesiologists. It is characterized by a markedly low intrapleural pressure which leads to exudation of fluid and red blood cells in the interstitium. Recognition of patients with predisposing factors for upper airway obstruction is important in the diagnosis which is often confused with pulmonary aspiration of gastric contents. Signs and symptoms are subtle and edema is usually self-limited. Our patient was management conservatively with maintenance of a patent airway and administration of supplemental oxygen and had a successful outcome. PMID:25886111

  5. [Heavy metal poisoning and renal injury in children].

    PubMed

    Rong, Li-Ping; Xu, Yuan-Yuan; Jiang, Xiao-Yun

    2014-04-01

    Along with global environmental pollution resulting from economic development, heavy metal poisoning in children has become an increasingly serious health problem in the world. It can lead to renal injury, which tends to be misdiagnosed due to the lack of obvious or specific early clinical manifestations in children. Early prevention, diagnosis and intervention are valuable for the recovery of renal function and children's good health and growth. This paper reviews the mechanism of renal injury caused by heavy metal poisoning in children, as well as the clinical manifestations, diagnosis, and prevention and treatment of renal injury caused by lead, mercury, cadmium, and chromium. PMID:24750823

  6. Xanthogranulomatous pyelonephritis with unconnected liver lesion.

    PubMed

    Karaman, Abdurrahman; Samdanc?, Emine; Do?an, Metin; Aksoy, Rauf Tu?rul; S???rc?, Ahmet; Demircan, Mehmet

    2011-07-01

    Xanthogranulomatous pyelonephritis is a chronic renal inflammation characterized by destruction and replacement of its parenchyma with granulomatous tissue. This uncommon condition is rare in children. We report on a 5-month-old male infant with a left renal and hepatic mass detected by ultrasound. The case was preoperatively misdiagnosed as Wilms' tumor and total nephrectomy and biopsy from liver lesion were performed. The subsequent histopathological findings confirmed the diagnosis of xanthogranulomatous pyelonephritis for renal and liver lesions. Increasing awareness of this disease should lead to the diagnosis being suspected preoperatively even if it is with unconnected tissue lesions. PMID:21094988

  7. Retained intra- thoracic surgical pack mimicking as recurrent aspergilloma.

    PubMed

    Mir, Ruquaya; Singh, Vikram P

    2012-12-01

    An intrathoracic gossypiboma is a rare condition. We are reporting a case of intrathoracicgossypiboma which was misdiagnosed as a recurrent aspergilloma. In our patient, the gossypiboma manifested as a pleural- based extra pulmonary mass which had a large contact area with the pleura and it displayed an extra pulmonary location. A retained surgical swab (gossypiboma) is a rare but an important complication of an intra- thoracic surgery. The diagnosis is usually overlooked, as in our case, resulting in delay of treatment, complications and a prolonged hospitalization. PMID:23373051

  8. Retained Intra- Thoracic Surgical Pack Mimicking as Recurrent Aspergilloma

    PubMed Central

    Mir, Ruquaya; Singh, Vikram P.

    2012-01-01

    An intrathoracic gossypiboma is a rare condition. We are reporting a case of intrathoracicgossypiboma which was misdiagnosed as a recurrent aspergilloma. In our patient, the gossypiboma manifested as a pleural- based extra pulmonary mass which had a large contact area with the pleura and it displayed an extra pulmonary location. A retained surgical swab (gossypiboma) is a rare but an important complication of an intra- thoracic surgery. The diagnosis is usually overlooked, as in our case, resulting in delay of treatment, complications and a prolonged hospitalization. PMID:23373051

  9. Malaria or flu? A case report of misdiagnosis

    PubMed Central

    Mahdavi, Seif Ali; Raeesi, Ahmad; Faraji, Leyla; Youssefi, Mohammad Reza; Rahimi, Mohammad Taghi

    2014-01-01

    We present and discuss elaborately a case of malaria misdiagnosis in a 27-year-old woman in Chalus, Mazandaran Province, North Iran in 2013. The patient has been complaining of fever, shivering and myalgia for three months. Although she visited two physicians during this time, the problem still remained owing to misdiagnose. Eventually in hospital after a precise examination on her thick and thin blood film, the causative agent of disease was diagnosed as plasmodium vivax. The patient received treatment accordingly and all clinical manifestations were vanished. PMID:25183146

  10. Malignant Mesothelioma of the Tunica Vaginalis: Presenting with Intermittent Scrotal Pain and Hydrocele

    PubMed Central

    Esen, Tar?k; Acar, Omer; Peker, Kamil; Sarman, Kemal; Musaoglu, Ahmet; Tefekli, Ahmet

    2012-01-01

    Paratesticular mesotheliomas are very rare tumors. In this paper, we present the management of a 38-year-old male patient with paratesticular malignant mesothelioma who was initially misdiagnosed and treated as recurrent epididymitis. After the final pathology report defining paratesticular mesothelioma during scrotal exploration, he underwent radical orchiectomy and hemiscrotal excision as a complementary, secondary procedure. His metastatic workup did not show any dissemination. Therefore, he did not receive any adjuvant treatment and remained disease-free for more than 2 years. PMID:22851974

  11. Adolescent With 68Ga DOTATATE-Avid Vertebral Hemangioma Mimicking Metastasis in PET Imaging.

    PubMed

    Skoura, Evangelia; Alshammari, Alshaima; Syed, Rizwan; Sajjan, Rakesh; Bomanji, Jamshed

    2015-07-01

    Ga DOTATATE PET/CT is a well-established method in the diagnostic workup of neuroendocrine tumors. We report the case of a 15-year-old adolescent boy with histologically proven appendiceal carcinoid tumor referred for Ga DOTATATE PET/CT to identify residual or metastatic disease. PET images showed increased tracer uptake in the body of T4 vertebra. This uptake could be misdiagnosed for bone metastasis, but CT characteristic appearance was in keeping with vertebral hemangioma. Both bone metastasis in carcinoid tumor and bone hemangiomas in adolescents are rare conditions, but the combined metabolic and morphological information on PET/CT can lead to the correct diagnosis. PMID:25783517

  12. Bipolar Disorder and ADHD: Comorbidity and Diagnostic Distinctions.

    PubMed

    Marangoni, Ciro; De Chiara, Lavinia; Faedda, Gianni L

    2015-08-01

    Attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder (BD) are neurodevelopmental disorders with onset in childhood and early adolescence, and common persistence in adulthood. Both disorders are often undiagnosed, misdiagnosed, and sometimes over diagnosed, leading to high rates of morbidity and disability. The differentiation of these conditions is based on their clinical features, comorbidity, psychiatric family history course of illness, and response to treatment. We review recent relevant findings and highlight epidemiological, clinical, family history, course, and treatment-response differences that can aid the differential diagnosis of these conditions in an outpatient pediatric setting. PMID:26084666

  13. Follicular dendritic cell sarcoma of the neck with pulmonary metastases.

    PubMed

    Fareed, Muhammad Mohsin; Memon, Muhammad Ali; Rashid, Azhar; Furrukh, Muhammad; Ahmed, Shoaib; Ghouri, Abdul Rauf; Khan, Amjad; Asghar, Abdul Shaheed

    2011-09-01

    We present a case of follicular dendritic cell sarcoma in a 48 years old Saudi female who reported with slowly progressive right sided extranodal neck mass associated with pulmonary metastasis. Clinical examination, histopathologic features including distinct immunostains combine together to make the rare diagnosis of follicular dendritic cell sarcoma. This entity is often misdiagnosed due to non-consideration in differential diagnosis of sarcoma. It carries a significant potential for regional as well as distant spread and hence categorized as intermediate risk malignancy. Clinical, histopathological and immunohistochemical aspects and therapeutic options of this unusual case are discussed. PMID:21914416

  14. Point-of-care ultrasound differentiates pyomyositis from cellulitis.

    PubMed

    Sauler, Allison; Saul, Turandot; Lewiss, Resa E

    2015-03-01

    Pyomyositis (PM) is an infection of skeletal muscle, often associated with an abscess. Patients typically have predisposing risk factors or are immune compromised. The disease is often misdiagnosed, mistreated,and goes undetected until late in the patient's clinical course.We present a case of a patient without obvious predisposing risk factors who complained of right thigh pain, swelling, redness, and fevers for 4 days.Point-of-care ultrasound revealed muscle edema and subcutaneous emphysema without signs of an overlying cellulitis. Point-of-care ultrasound consequently led to an earlier diagnosis of PM and directly affected the immediate patient care in the emergency department. PMID:25245285

  15. Cytologic findings and potential pitfalls in proliferative myositis and myositis ossificans diagnosed by fine needle aspiration cytology: report of four cases and review of the literature.

    PubMed

    Klapsinou, Eirini; Despoina, Proestou; Dimitra, Daskalopoulou

    2012-03-01

    Proliferative myositis (PM) and myositis ossificans (MO) are two uncommon, benign pseudosarcomatous lesions of soft tissue. Despite their benign nature, they are often misdiagnosed for malignant soft tissue tumors because of their alarming clinical presentation. Fine needle aspiration cytology (FNAC) is a quick and simple method that can accurately diagnose such lesions, provided that the cytopathologist is adequately familiar with the cytomorphological features of these lesions as opposed to the features of sarcomas. In this report, we present three cases of PM and one case of MO diagnosed by FNAC. Their cytomorphological features are described, and related literature is reviewed. PMID:20890998

  16. Unusual sequela from a pencil stab wound reveals a retained graphite foreign body.

    PubMed

    Seitz, Iris A; Silva, Bradley A; Schechter, Loren S

    2014-08-01

    Penetrating pencil-tip injuries are common among children and usually resolve without long-term sequelae. However, failure to detect and remove embedded pencil fragments can result in increased morbidity or misdiagnoses of other, more serious, conditions. We report on the case of a 10-year-old boy stabbed with a pencil on his right chin. Initial treatment in the emergency department included irrigation and closure of the laceration. Following suture removal, the patient returned to the emergency department (with bright-purple drainage from the wound site). Radiographic evaluation led to the discovery of an embedded foreign body requiring surgical removal. PMID:25098803

  17. Retinacular disorders of the ankle and foot.

    PubMed

    Demondion, Xavier; Canella, Clarissa; Moraux, Antoine; Cohen, Michel; Bry, Régis; Cotten, Anne

    2010-09-01

    The retinacula of the ankle are distinct structures defined as regions of localized thickening of the crural fascia covering the deep structures of the distal portion of the leg, ankle, and foot. Their role is to maintain the approximation of the tendons to the underlying bone. The retinacula of the ankle and foot contain the extensor retinaculum, the peroneal retinaculum, and the flexor retinaculum. Knowledge of the normal anatomy and imaging appearance of these structures is essential for the depiction of their injuries. Even though they may provide an explanation for chronic and unexplained residual pain after an injury, they are frequently overlooked or misdiagnosed. PMID:20539954

  18. Pulmonary Artery Angiosarcoma Confused with Acute Pulmonary Thromboembolism: Focusing on Clinical and Echocardiographic Features in the Differentiation of Two Categories

    PubMed Central

    Kim, Mi Joo; Kim, Min Su; Park, Kwang-In; Lee, Choong-Sik; Na, Myung Hoon; Lee, Jae-Hwan; Choi, Si Wan; Jeong, Jin-Ok; Seong, In-Whan

    2015-01-01

    Although pulmonary artery angiosarcoma is rare, it can be misdiagnosed as pulmonary embolism because of its similar clinical and diagnostic features. The diagnosis is often delayed and the misdiagnosis brings unnecessary treatment. Because we made a wrong diagnosis of pulmonary artery angiosarcoma as an acute pulmonary embolism, we did thrombolytic therapy which could be dangerous to the patient. In this case report, we focused on the clinical and echocardiographic features of pulmonary artery angiosarcoma which can be used in differentiating the diagnosis from pulmonary embolism. PMID:25883757

  19. Intraperitoneal Follicular Dendritic Cell Sarcoma: Role of Chemotherapy and Bone Marrow Allotransplantation in Locally Advanced Disease?

    PubMed Central

    Liberale, G; Keriakos, K; Azerad, MA; De Saint Aubain, N; El Nakadi, I

    2015-01-01

    We describe a case of a 44 year-old woman diagnosed with follicular dendritic cell sarcoma (FDCS). FDCS is a very rare disease affecting the dendritic antigen presenting cells and is often misdiagnosed. Surgery is considered the best treatment modality, followed by chemotherapy. In our case, surgical excision was not possible, therefore the patient received two lines of chemotherapy followed by bone marrow allotransplantation, then a third line of chemotherapy with a complete metabolic response seen on PET/computed tomography (CT) follow-up 29 months later. A review of the literature has been performed. PMID:25698886

  20. Severe Transient Hyperglycemia in a Prediabetic Patient during Mild Acute Pancreatitis.

    PubMed

    Reghina, Aura Diana; Craciun, Silvia; Fica, Simona

    2015-01-01

    A 30-year-old obese male patient had been diagnosed with diabetes mellitus due to acute hyperglycemia and ketonuria. He also presented with severe hypertriglyceridemia and high levels of serum lipase. He was initially misdiagnosed with type 1 diabetes and treated with insulin for one month. At two months from first presentation, pancreatic antibodies were negative, and the C-peptide level was normal. A1c level was 5.9% without insulin treatment. The association between diabetes mellitus and acute pancreatitis is well established. We reported a case of severe transient hyperglycemia during mild acute pancreatitis in a metabolically ill patient. PMID:25918533

  1. Cutaneous Adverse Reactions of Amiodarone

    PubMed Central

    Jaworski, Krzysztof; Walecka, Irena; Rudnicka, Lidia; Gnatowski, Maciej; Kosior, Dariusz A.

    2014-01-01

    Dermatological complications of amiodarone are commonly encountered problems in therapy. The incidence in the population of patients with prolonged use of amiodarone reaches nearly 75% according to various sources. Nevertheless, they are often misdiagnosed or overlooked. The aim of this review is to present the current state of knowledge about skin changes induced by amiodarone, including phototoxic and photoallergic reactions, as well as hyperpigmentation. In most cases, the adverse effects are reversible and disappear after discontinuation of the drug. Although the dermatological complications usually do not influence the outcome of the therapy and rarely cause discontinuation of treatment, they have a great impact on patient quality of life. PMID:25413691

  2. Pitfalls in colour photography of choroidal tumours

    PubMed Central

    Schalenbourg, A; Zografos, L

    2013-01-01

    Colour imaging of fundus tumours has been transformed by the development of digital and confocal scanning laser photography. These advances provide numerous benefits, such as panoramic images, increased contrast, non-contact wide-angle imaging, non-mydriatic photography, and simultaneous angiography. False tumour colour representation can, however, cause serious diagnostic errors. Large choroidal tumours can be totally invisible on angiography. Pseudogrowth can occur because of artefacts caused by different methods of fundus illumination, movement of reference blood vessels, and flattening of Bruch's membrane and sclera when tumour regression occurs. Awareness of these pitfalls should prevent the clinician from misdiagnosing tumours and wrongfully concluding that a tumour has grown. PMID:23238442

  3. Anti-NMDA Receptor Encephalitis in a Pregnant Woman

    PubMed Central

    Kim, Jiyoung; Park, Seung Ha; Jung, Yu Ri; Park, Soon Won; Jung, Dae Soo

    2015-01-01

    Anti N-methyl-D-aspartate (NMDA) receptor encephalitis is one of the most common types of autoimmune synaptic encephalitis. Anti-NMDA receptor encephalitis commonly occurs in young women with ovarian teratoma. It has variable clinical manifestations and treatment responses. Sometimes it is misdiagnosed as a psychiatric disorder or viral encephalitis. To the best of our knowledge, anti-NMDA receptor encephalitis is a rare condition in pregnant women. We report a case of anti-NMDA receptor encephalitis in a pregnant woman who presented with abnormal behavior, epileptic seizure, and hypoventilation. PMID:26157673

  4. An Unusual Presentation of Charcot Arthropathy Caused by Syringomyelia Mimicking a Soft Tissue Tumor

    PubMed Central

    Atalar, Ebru; Ataoglu, Baybars

    2014-01-01

    Charcot arthropathy is a chronic, degenerative condition and is associated with decreased sensorial innervation. Numerous causes of this arthropathy have been described. Here we report a case of neuropathic arthropathy secondary to syringomyelia which was misdiagnosed as a soft tissue tumor and treated surgically and additionally with radiotherapy at another institution. The patient had clinical and radiological signs of syringomyelia, associated with a limited range of motion, swelling, and pain in the affected joint. Neuropathic arthropathy, although less common, should be considered in cases of unexplained joint swelling, pain, and limited range of motion of the affected joint. PMID:25126434

  5. Recurrent cutaneous abscesses in two Italian family members

    PubMed Central

    Cantisani, Carmen; Richetta, Antonio G.; Bitonti, Andrea; Curatolo, Pietro; Ferretti, Gianfranco; Mattozzi, Carlo; Luca, Melis; Silvestri, Emidio; Calvieri, Stefano

    2010-01-01

    Environmental mycobacteria are the causative factors of an increasing number of infections worldwide. Cutaneous infections as a result of such mycobacteria are often misdiagnosed, and their treatment is difficult since they can show in vivo and in vitro multidrug resistance. Absence of pathognomonic clinical signs and variable histological findings often delay diagnosis. We report a case of localized recurrent soft tissue swelling by Mycobacterium marinum in 2 members of the same family. The cases are being reported for their uncommon clinical presentation and the associated etiological agent. Patients recovered completely following therapy with rifampicin 600 mg plus isoniazide 300 mg daily for 45 days. PMID:24470891

  6. Fracture of the Medial Tibial Sesamoid Bone of the Foot-Case Report

    PubMed Central

    K.M., Srinath; Jeevannavar, Santosh S.; Shettar, Chidendra M.

    2015-01-01

    The sesamoid bone ligament complex of foot contains two sesamoid bones one medial tibial sesamoid and other lateral fibular sesamoid bone, both embedded in the plantar ligament beneath first metatarsal head. The incidence of medial tibial sesamoid bone fracture is rare. Clinically they are often misdiagnosed as soft tissue injuries and often missed. We present a case of fracture medial tibial sesamoid bone in a young athlete who was diagnosed radiologically and treated conservatively with activity restriction and foot wear modification. Our case draws attention to this easily treatable fracture and outlines the investigative modalities in diagnosing this fracture. PMID:26023612

  7. Adenomatoid odontogenic tumor: As an unusual mandibular manifestation

    PubMed Central

    Sharma, Neeraj; Passi, Sidhi; Kumar, Vinay V.

    2012-01-01

    Adenomatoid odontogenic tumor (AOT) is a rare odontogenic tumor which is often misdiagnosed as odontogenic cyst and accounts for about 1% until 9% of all odontogenic tumors. It is predominantly found in young and female patients, located more often in the maxilla in most cases associated with an unerupted permanent tooth. It is a benign (hamartomatous), noninvasive lesion with slow but progressive growth. There are three variants of AOT: follicular, extrafollicular, and peripheral. We report a rare case of follicular-type AOT in the mandible of a 14-year-old male patient who presented with right -sided jaw swelling. PMID:22629062

  8. Danazol: An Effective Option in Acquired Amegakaryocytic Thrombocytopaenic Purpura

    PubMed Central

    Mulroy, E.; Gleeson, S.; Chiruka, S.

    2015-01-01

    Acquired amegakaryocytic thrombocytopaenic purpura (AATP) is a rare haematological condition characterised by isolated thrombocytopaenia with normal other cell lines. It is often initially misdiagnosed as immune thrombocytopaenic purpura but has characteristic bone marrow findings of reduced megakaryocyte numbers. The optimal treatment of AATP is not clearly defined but revolves around immunosuppressive therapies. We report a case of successful treatment of AATP with danazol, an antioestrogenic medication. We also review the aetiologies and pathogenesis of the disorder and suggest that danazol should be considered as an effective alternative to potent immunosuppression in AATP. PMID:25945269

  9. Scoliosis secondary to ganglioneuroma: a case report and up to date literature review.

    PubMed

    D'Eufemia, Patrizia; Properzi, Enrico; Palombaro, Marta; Lodato, Valentina; Mellino, Loretta; Tetti, Martina; Martini, Lorena; Persiani, Pietro

    2014-07-01

    Idiopathic scoliosis is the most common form of spinal deformity in children. However, secondary causes of scoliosis, such as ganglioneuroma, should be always considered to avoid wrong diagnosis, and further investigations are required when there are atypical signs. We report a case of ganglioneuroma misdiagnosed as idiopathic scoliosis and review the literature to identify the red flags useful for physicians during the evaluation of a child with scoliosis. On the basis of both clinical and radiographic criteria that emerged from this study, we propose an algorithm that could help in the differential diagnosis, suggesting when to perform an MRI. PMID:24681491

  10. Primary sinonasal tuberculosis confined to the unilateral maxillary sinus

    PubMed Central

    Kim, Kyung Yeon; Bae, Jung Ho; Park, Jee Soo; Lee, Seung-Sin

    2014-01-01

    Extrapulmonary tuberculosis is not rare and occurs mainly in the head and neck region. Cervical tuberculous lymphadenopathy is the most common form of extrapulmonary tuberculosis. Sinonasal tuberculosis is known to occur very rarely due to the protective functions of sinonasal mucosa. Although some signs of sinonasal tuberculosis may be present, such as associated facial abscesses, the symptoms and signs are usually nonspecific. Clinical suspicion is important for timely diagnosis and proper management of sinonasal tuberculosis due to its rarity and nonspecific clinical presentation. We report a case of tuberculosis confined to the unilateral maxillary sinus that was first misdiagnosed as recurrent rhinosinusitis after endoscopic sinus surgery. PMID:24551309

  11. The flexible adult flatfoot: anatomy and pathomechanics.

    PubMed

    Walters, Jeremy L; Mendicino, Samuel S

    2014-07-01

    Adult acquired flatfoot deformity is generally associated with a collapsing medial longitudinal arch and progressive loss of strength of the tibialis posterior tendon. It is most commonly associated with posterior tibial tendon dysfunction that can have an arthritic or traumatic cause. With an increasing population of obese patients, the often misdiagnosed and overlooked posterior tibial tendon dysfunction will only continue to present more often in the foot and ankle specialist's office. This article focuses on the anatomy, classification, and pathomechanics of the flexible adult flatfoot. PMID:24980923

  12. [Villous adenoma of the rectum with hypotensive dehydration and extrarenal uremia (author's transl)].

    PubMed

    Weise, H J; Farago, M

    1976-04-01

    Rare cases of recto-sigmoid villous adenoma may show profuse mucous discharge per anum as a cardinal symptom which consequently leads to considerable losses of water and electrolytes with imminent exsiccosis uremia. In spite of these typical clinical symptoms, this disease, which occurs mainly in older people, is frequently misdiagnosed and usually only recognized late. Because of the increased danger of malignant degeneration, the poor control of this leakage of electrolytes by conservative therapy and the tendency to local relapse of this tumor, there is an absolute indication for radical surgical treatment. PMID:817175

  13. Various faces of Hansen's disease.

    PubMed

    Raval, R C

    2012-01-01

    Leprosy is a chronic granulomatous disease caused by Mycobacterium leproe. Leprosy once considered a taboo is still misdiagnosed and underdiagnosed. In many cases leprosy is treated as common disorders like psoriasis, pyoderma, angioedema, pre vitiligo. Leprosy can present in many diverse ways which can be confused with many treatable and non treatable, infectious and non infectious forms. Leprosy is considered on the verge of elimination. But Leprosy cases are being newly diagnosed day by day. Here we are presenting 4 atypical cases of leprosy which did not seem to have classical presentation but were diagnosed as leprosy when investigated. PMID:23236704

  14. Mycobacterial spindle cell pseudotumour of the brain in a patient with sarcoidosis.

    PubMed

    Ismail, Iyad; Carey, Martyn; Trotter, Simon; Kunst, Heinke

    2015-01-01

    Mycobacterial spindle cell pseudotumours (MSP) are benign lesions characterised by local proliferation of spindle-shaped histiocytes caused by mycobacterial infections. Cerebral MSP due to Mycobacterium avium intracellulare (MAI) infection is rare, and is often misdiagnosed clinically and radiologically as a brain tumour. We present a case with underlying sarcoidosis and known pulmonary MAI infection presenting with partial seizures and headaches. Imaging of the brain revealed a solitary extra axial tumour within the right temporal area. Biopsy of the tumour showed evidence of MPS due to MAI infection. Prolonged treatment with antituberculous therapy showed complete resolution of the cerebral lesion. PMID:26153278

  15. Cone beam CT assisted re-treatment of class 3 invasive cervical resorption.

    PubMed

    Krishnan, Unni; Moule, Alex J; Alawadhi, Abdulwahab

    2015-01-01

    Invasive cervical root resorption is an uncommon external root resorption which initiates at the cervical aspect of the tooth. This case report involves a case of cervical root resorption which was initially misdiagnosed and managed as cervical root caries. It was later diagnosed with cone beam CT and the lesion microsurgically removed and restored with resin modified glass ionomer cement. The importance of increasing awareness of this uncommon pathology and the role of cone beam CT in mapping the extent of the lesion is emphasised. PMID:25795743

  16. Multimodal Imaging for the Diagnosis of an Atypical Case of Central Serous Chorioretinopathy

    PubMed Central

    Kahloun, Rim; Chebbi, Amel; Amor, Sofiene Ben; Ksiaa, Imen; Nacef, Leila; Khairallah, Moncef

    2014-01-01

    We report a case of a 52-year-old woman presented with atypical central serous chorioretinopathy (CSCR) that had been misdiagnosed as posterior uveitis and treated with systemic corticosteroids and immunosuppressive therapy, with subsequent severe chorioretinal damage. Diagnosis was straightened through multimodal imaging. Anatomical improvement was achieved after discontinuation of corticosteroids and intravitreal injection of bevacizumab. However, visual acuity remained severely impaired in one eye. Failure to differentiate atypical CSCR from inflammatory chorioretinal diseases may lead to severe and irreversible visual impairment. Multimodal imaging helps recognition of the atypical presentations of CSCR, avoiding misdiagnosis and inappropriate management. PMID:25371645

  17. Chronic ischaemic colitis in a 48 year old man: an unusual presentation.

    PubMed

    Lau, Kimberley; Oommen, Chitakattil

    2013-06-01

    Ischaemic colitis typically presents with an acute abdominal pain and distension with bloody diarrhoea. However, this can vary and the condition is frequently missed or misdiagnosed, especially if the patient presents with chronic symptoms. Herein, we report a case of chronic presentation of ischaemic colitis in a 48-year-old man with a history of myocardial infarction. This report highlights the importance of having ischaemic colitis as a differential diagnosis whenever a patient with a history of arteriosclerosis presents with atypical chronic abdominal pain. PMID:24426515

  18. Osteoid osteoma in the neck of the Scapula; A misleading case

    PubMed Central

    Rouhani, Alireza; Mohajerzadeh, Saeid; Ansari, Marouf

    2014-01-01

    Osteoid osteoma is a benign bone tumor that when located on the base of the coracoids process of the scapula is very rare and diagnosis and treatment is often delayed because of its rarity. Almost any bone can be involved, but half of cases involve the femur or tibia. The radiologic features of osteoid osteoma are well known, but these tumors may present with unusual features and be easily misdiagnosed. In this report, we present a case of osteoid osteoma of the neck of the left scapula that took almost 27 months to be diagnosed accurately. PMID:25386589

  19. Myocarditis in athlete and myocardial bridge: An innocent bystander?

    PubMed

    Quaranta, Federico; Guerra, Emanuele; Sperandii, Fabio; De Santis, Francesco; Pigozzi, Fabio; Calò, Leonardo; Borrione, Paolo

    2015-05-26

    Myocarditis is a bacterial or viral inflammatory disease, often unnoticed or misdiagnosed. Athletes with myocarditis must stop practicing their activity since International medical Literature described some cases of sudden death. In the present report, we describe a case of an asymptomatic, apparently healthy, competitive athletes, who was diagnosed a myocarditis and as incidental finding a myocardial bridging. We focused the attention on the importance of anamnesis, electrocardiogram and athletes' entourage for the diagnosis of such insidious pathologies and we evaluated the follow up, focusing the attention on electrocardiogram changes as well as on restitution ad integrum and prognosis, especially for the athletes. PMID:26015860

  20. Myocarditis in athlete and myocardial bridge: An innocent bystander?

    PubMed Central

    Quaranta, Federico; Guerra, Emanuele; Sperandii, Fabio; De Santis, Francesco; Pigozzi, Fabio; Calò, Leonardo; Borrione, Paolo

    2015-01-01

    Myocarditis is a bacterial or viral inflammatory disease, often unnoticed or misdiagnosed. Athletes with myocarditis must stop practicing their activity since International medical Literature described some cases of sudden death. In the present report, we describe a case of an asymptomatic, apparently healthy, competitive athletes, who was diagnosed a myocarditis and as incidental finding a myocardial bridging. We focused the attention on the importance of anamnesis, electrocardiogram and athletes’ entourage for the diagnosis of such insidious pathologies and we evaluated the follow up, focusing the attention on electrocardiogram changes as well as on restitution ad integrum and prognosis, especially for the athletes. PMID:26015860

  1. Congenital and acquired neutropenia consensus guidelines on diagnosis from the Neutropenia Committee of the Marrow Failure Syndrome Group of the AIEOP (Associazione Italiana Emato-Oncologia Pediatrica).

    PubMed

    Fioredda, Francesca; Calvillo, Michaela; Bonanomi, Sonia; Coliva, Tiziana; Tucci, Fabio; Farruggia, Piero; Pillon, Marta; Martire, Baldassarre; Ghilardi, Roberta; Ramenghi, Ugo; Renga, Daniela; Menna, Giuseppe; Barone, Angelica; Lanciotti, Marina; Dufour, Carlo

    2011-07-15

    Congenital and acquired neutropenia are rare disorders whose frequency in pediatric age may be underestimated due to remarkable differences in definition or misdiagnosed because of the lack of common practice guidelines. Neutropenia Committee of the Marrow Failure Syndrome Group (MFSG) of the AIEOP (Associazione Italiana Emato-Oncologia Pediatrica) elaborated this document following design and methodology formerly approved by the AIEOP board. The panel of experts reviewed the literature on the topic and participated in a conference producing a document which includes a classification of neutropenia and a comprehensive guideline on diagnosis of neutropenia. PMID:21448998

  2. Recurrent Syncope Associated with Lung Cancer

    PubMed Central

    Zhang, Dingguo; Wang, Liansheng; Yang, Zhijian

    2015-01-01

    Syncope is an important problem in clinical practice with many possible causes that might be misdiagnosed. We present an unusual case of syncope, which has a normal chest X-ray. Exercise EKG and coronary angioplasty results confirmed the existence of serious coronary heart disease. The patient was treated with coronary stent transplantation. However, scope occurred again and the elevated tumor makers cytokeratin-19-fragment and neuron-specific enolase revealed the bronchogenic carcinoma, which was confirmed by enhanced CT examination. The treatment of carcinoma by chemotherapy was indeed sufficient for prompt elimination of the syncope symptoms.

  3. Catastrophic Intramedullary Abscess Caused by a Missed Congenital Dermal Sinus

    PubMed Central

    Dho, Yun-Sik; Kim, Seung-Ki; Wang, Kyu-Chang

    2015-01-01

    Congenital dermal sinus (CDS) is a type of occult spinal dysraphism characterized by a midline skin dimple. A 12-month-old girl presented with fever and ascending quadriparesis. She had a midline skin dimple in the upper sacral area that had been discovered in her neonatal period. Imaging studies revealed a holocord intramedullary abscess and CDS. Overlooking CDS or misdiagnosing it as benign sacrococcygeal dimple may lead to catastrophic infection and cause serious neurological deficits. Therefore, further imaging work-up or consultation with a pediatric neurosurgeon is recommended following discovery of any atypical-looking dimples in the midline. PMID:25810867

  4. Actinomyces graevenitzii pulmonary abscess mimicking tuberculosis in a healthy young man

    PubMed Central

    Gliga, Smaranda; Devaux, Mathilde; Woimant, Marine Gosset; Mompoint, Dominique; Perronne, Christian; Davido, Benjamin

    2014-01-01

    Pulmonary actinomycosis is a rare disease that is often misdiag-nosed as tuberculosis or lung cancer. Actinomyces graevenitzii is a relatively new recognized Actinomyces species isolated from various clinical samples. The authors report a case of pulmonary actinomycosis caused by A graevenitzii. A computed tomography examination revealed an excavated consolidation in the middle right lobe of a previously healthy young man who presented with a long history of moderate cough. Cultures of the bronchoalveolar lavage fluid confirmed the diagnosis of pulmonary abscess caused by A gravenitzii. At the three-month follow-up consultation and, after six weeks of high-dose amoxicillin, the pulmonary lesion had completely disappeared. PMID:25493591

  5. Disseminated alveolar hydatid disease resembling a metastatic malignancy: a diagnostic challenge-a report of two cases.

    PubMed

    Bulakci, Mesut; Yilmaz, Erdem; Cengel, Ferhat; Gocmez, Ahmet; Kartal, Merve Gulbiz; Isik, Emine Goknur; Celenk, Erhan; Yegen, Gulcin; Salmaslioglu, Artur

    2014-01-01

    Alveolar hydatid disease or alveolar echinococcosis is a disease of the parasite Echinococcus multilocularis that is potentially fatal if left untreated. It primarily involves the liver but can be disseminated to other organs like the lungs and the brain by hematogenous route. Multiorgan involvement and the aggressive appearance of lesions make alveolar hydatid disease easy to confuse with a metastatic malignancy. For this reason, histopathological confirmation is essential for definite diagnosis. We present the imaging features of this disease in two patients in order to emphasize that these lesions can be easily misdiagnosed as malignancies. PMID:25374743

  6. Disseminated Alveolar Hydatid Disease Resembling a Metastatic Malignancy: A Diagnostic Challenge—A Report of Two Cases

    PubMed Central

    Bulakci, Mesut; Cengel, Ferhat; Gocmez, Ahmet; Kartal, Merve Gulbiz; Isik, Emine Goknur; Celenk, Erhan

    2014-01-01

    Alveolar hydatid disease or alveolar echinococcosis is a disease of the parasite Echinococcus multilocularis that is potentially fatal if left untreated. It primarily involves the liver but can be disseminated to other organs like the lungs and the brain by hematogenous route. Multiorgan involvement and the aggressive appearance of lesions make alveolar hydatid disease easy to confuse with a metastatic malignancy. For this reason, histopathological confirmation is essential for definite diagnosis. We present the imaging features of this disease in two patients in order to emphasize that these lesions can be easily misdiagnosed as malignancies. PMID:25374743

  7. Location of recurrent asymptomatic ovarian cancer through endoscopic ultrasound

    PubMed Central

    Carvalho, Joaquim; Formighieri, Beatriz; Filippi, Sheila; Rossini, Lucio

    2015-01-01

    Ovarian cancer is frequent and recurrence happens in about 75% of patients. As it presents high rates of relapse, the exams for this diagnosis are widely discussed. Beside this, there have been discussions about benefits for early anatomic diagnosis and whether endoscopic ultrasound (EUS) can be used to track the relapse of the disease. We present a case, in which anatomic location and histological definition of an asymptomatic recurrence of the ovarian cancer was misdiagnosed with conventional methods, but was possible through EUS. PMID:25789287

  8. Prevalence of methicillin-resistant Staphylococcus aureus in mammals of the Royal Zoological Society of Antwerp, Belgium.

    PubMed

    Vercammen, Francis; Bauwens, Luc; De Deken, Redgi; Brandt, Jef

    2012-03-01

    Contrary to the numerous reports on methicillin-resistant Staphylococcus aureus (MRSA) in domestic animals, only three articles concerning zoo animals are documented in the literature. A skin infection of an African elephant (Loxodonta africana) calf was most likely acquired from an infected caretaker. Another zoo detected MRSA in the rumen content of a mouflon (Ovis aries), and, in a third facility, it was reported in a fistulous wound at the coronary band of a digit of an Indian rhinoceros (Rhinoceros unicornis). In the present study, which lasted 13 months and involved 93 different individual mammals that belonged to 40 species and 19 families housed in the Royal Zoological Society of Antwerp, Belgium, this study reports the absence of MRSA in swabs of nostrils, skins, conjunctiva, vulva, abscess, and arm rests in public spaces. Samples were enriched overnight and inoculated on a selective chromogenic medium. PMID:22448524

  9. Pseudomazzia macrolabiata n.gen.,n.sp. (Nematoda: Spiruridae: Mazziinae) from the fish Pomadasys olivaceus of Karachi coast.

    PubMed

    Bilqees, Fatima Mujib; Ghazi, Rafia Rehana; Haseeb, Muhammad Farooq

    2005-01-01

    A nematode Pseudomazzia macrolabiata of a new genus and a new species is described here from the intestine of the fish Pomadasys olivaceus of Karachi coast. The new genus is characterized by having an enlarged head region with three large prominent lips protruding externally from the head, a prominent buccal cavity and with a proboscis. The esophagus is not clearly divided into muscular and glandular parts and the intestine is simple. The male has very unequal spicules, dissimilar in shape. The caudal alae are prominent supported by several pedunculate papillae including 5 pre anal pairs and two pairs including one pro-anal and one post-anal. The female vulva is near the middle of the body. The tail is elongate, bluntly pointed and is provided with a terminal forked spike. The eggs are thin shelled and oval in shape. PMID:17124692

  10. B cells Regulate Macrophage Phenotype and Response to Chemotherapy in Squamous Carcinomas

    PubMed Central

    Medler, Terry R.; Gunderson, Andrew J.; Johansson, Magnus; Bornstein, Sophia; Bergsland, Emily; Steinhoff, Martin; Li, Yijin; Gong, Qian; Ma, Yan; Wiesen, Jane F.; Wong, Melissa H.; Kulesz-Martin, Molly; Irving, Bryan; Coussens, Lisa M.

    2014-01-01

    SUMMARY B cells foster squamous cell carcinogenesis (SCC) through deposition of immunoglobulin-containing immune complexes in premalignant tissue and Fc?receptor-dependent activation of myeloid cells. Since human SCCs of the vulva and head and neck exhibited hallmarks of B cell infiltration, we examined B cell-deficient mice and found reduced ability to support SCC growth. Although ineffective as a single agent, treatment of mice bearing pre-existing SCCs with B cell-depleting ?CD20 monoclonal antibodies improved response to platinum- and taxol-based chemotherapy. Improved chemo-responsiveness was dependent on altered chemokine expression by macrophages that fostered tumor infiltration of activated CD8+ T cells via CCR5-dependent mechanisms. These data reveal that B cells, and the downstream myeloid-based pathways they regulate, represent tractable targets for anti-cancer therapy in select tumors. PMID:24909985

  11. A new species of Syphacia (Seuratoxyuris) (Nematoda: Oxyuridae) from Sooretamys angouya Fischer, 1814 (Rodentia: Cricetidae) in Argentina.

    PubMed

    Robles, María del Rosario; Panisse, Guillermo; Navone, Graciela Teresa

    2014-11-01

    Syphacia (Seuratoxyuris) hugoti n. sp. (Nematoda: Oxyuridae) is described from the cecum of Sooretamys angouya (Cricetidae: Sigmodontinae: Oryzomyini) captured in Formosa Province, Argentina. The diagnosis of the subgenus is emended, and the new species is separated from eight congeners by the distribution of submedian papillae and amphids, shape of the cephalic plate, presence of deirids, absence of cervical and lateral alae, length of the spicule, structure of the accessory hook of the gubernaculum and distance of excretory pore and vulva from the anterior extremity. The analysis suggests that S. (Se.) oryzomyos should be removed from Seuratoxyuris and redesignated as S. (Syphacia) oryzomyos n. comb. To date, of the species of Syphacia found in South and North American, 7 parasitize Oryzomyini rodents, of which two are distributed in Argentina. The present study constitutes the first record of the subgenus Seuratoxyuris from Argentina and the third record of a Syphacia species from rodents of the tribe Oryzomyini. PMID:24995650

  12. Two new species and a new record of Comesomatidae (Nematoda, Araeolaimida) from Southern Hikurangi Margin, New Zealand.

    PubMed

    Rosli, Norliana; Leduc, Daniel; Probert, P Keith

    2014-01-01

    We describe two new species and provide one new species record of the family Comesomatidae from a submarine canyon habitat on the Southern Hikurangi margin, New Zealand. Vasostoma hexodontium n. sp. is characterized by having an amphideal fovea with three turns, buccal cavity with six teeth and gubernaculum with long and straight caudal apophyses. Sabatieria dispunctata n. sp. is characterized by the absence of cuticle punctations, large amphideal fovea with 4.5 turns, pharynx with posterior bulb, absence of pre-cloacal supplements, strongly arcuate and cuticularized spicules, simple gubernaculum with short caudal apophyses, and vulva opening directed posteriorly. Laimella subterminata Chen & Vincx, 2000, which was originally described from the Beagle Channel and the Magellan Strait (Chile), is recorded from the Southwest Pacific for the first time.  PMID:25543753

  13. LASER BIOLOGY AND MEDICINE: Combined application of optical methods to increase the information content of optical coherent tomography in diagnostics of neoplastic processes

    NASA Astrophysics Data System (ADS)

    Kuranov, R. V.; Sapozhnikova, V. V.; Shakhova, N. M.; Gelikonov, V. M.; Zagainova, E. V.; Petrova, S. A.

    2002-11-01

    A combined application of optical methods [optical coherent tomography (OCT), cross-polarisation optical coherent tomography, and fluorescence spectroscopy] is proposed for obtaining information on morphological and biochemical changes occurring in tissues in norm and pathology. It is shown that neoplastic and scar changes in esophagus can be distinguished using a combination of polarisation and standard OCT due to the difference between the depolarising properties of the tissues caused by the structural properties of collagenic fibres in stroma. It is shown that OCT combined with fluorescence spectroscopy with the use of 5-aminolevulinic acid is promising for determining the boundaries of carcinoma of the uterine cervix and vulva. It is found that the tumour boundary detected by optical methods coincides with the morphological boundary and extends beyond colposcopically determined boundary by about 2 mm.

  14. Amelanotic vulvar melanoma: a case report.

    PubMed

    Filippetti, Rossella; Pitocco, Rossella

    2015-06-01

    A 14-year-old girl stated that she has vulvar pruritus, pain, and bleeding and underwent a complete gynecological evaluation during which a suspicious 2-cm achromic lesion on her vulva was observed. Initially, it was suspected to be a pyogenic granuloma, in relation to the patient's age. A biopsy was taken, and a histopathological diagnosis of amelanotic mucosal melanoma was made. Pyogenic granuloma is a reactive hyperproliferation vascular response to trauma or other stimuli. It predominantly occurs in the second decade of life in young females, in relation to the vascular effects of female hormones. Primary mucosal melanoma is a rare and aggressive neoplasm, characterized by a higher aggressiveness and a worse prognosis than her cutaneous counterpart. The female genital tract is the second most common site of onset of mucosal melanoma; it represents the 3% of melanomas diagnosed in women. PMID:25993407

  15. The role of human papilloma virus in urological malignancies.

    PubMed

    Heidegger, Isabel; Borena, Wegene; Pichler, Renate

    2015-05-01

    Human papillomavirus (HPV) is associated with cancer of the cervix uteri, penis, vulva, vagina, anus and oropharynx. However, the role of HPV infection in urological tumors is not yet clarified. HPV appears not to play a major causative role in renal and testicular carcinogenesis. However, HPV infection should be kept in mind regarding cases of prostate cancer, as well as in a sub-group of patients with bladder cancer with squamous differentiation. Concerning the role of HPV in penile cancer incidence, it is a recognized risk factor proven in a large number of studies. This short review provides an update regarding recent literature on HPV in urological malignancies, thereby, also discussing possible limitations on HPV detection in urological cancer. PMID:25964524

  16. The anesthetic action of ethanol analyzed by genetics in Caenorhabditis elegans

    SciTech Connect

    Hong, Mingi; Choi, Myung Kyu [Research Center for Functional Cellulomics, Institute of Molecular Biology and Genetics, School of Biological Sciences, Seoul National University, 56-1 Gwanak-gu, Shillim-dong, Seoul 151-742 (Korea, Republic of); Lee, Junho [Research Center for Functional Cellulomics, Institute of Molecular Biology and Genetics, School of Biological Sciences, Seoul National University, 56-1 Gwanak-gu, Shillim-dong, Seoul 151-742 (Korea, Republic of)], E-mail: elegans@snu.ac.kr

    2008-02-29

    Acute exposure to ethanol causes paralysis at high concentrations in the nematode Caenorhabditis elegans. We set out to elucidate the mechanism of the anesthetic action of ethanol by genetic approaches. We identified nine mutations that conferred reduced sensitivity to ethanol after chemical, irradiation, or transposon insertion mutagenesis. Of these nine, we further characterized five mutations that defined four genes, jud-1-jud-4. Analysis of the phenotypes of the animals heterozygous for two unlinked genes revealed that jud-1 and jud-3 act synergistically in a gene dose-dependent manner. We cloned jud-4 and found that it encodes a protein with limited homology to human Homer proteins. jud-4 was expressed in the hypodermis and vulva muscles, suggesting that this gene acts in tissues directly exposed to the external environment. Characterization of the other mutations identified in this study will facilitate the elucidation of the molecular mechanism for the anesthetic action of ethanol.

  17. LIN-39/Hox triggers cell division and represses EFF-1/fusogen-dependent vulval cell fusion

    PubMed Central

    Shemer, Gidi; Podbilewicz, Benjamin

    2002-01-01

    General mechanisms by which Hox genes establish cell fates are known. However, a few Hox effectors mediating cell behaviors have been identified. Here we found the first effector of LIN-39/HoxD4/Dfd in Caenorhabditis elegans. In specific vulval precursor cells (VPCs), LIN-39 represses early and late expression of EFF-1, a membrane protein essential for cell fusion. Repression of eff-1 is also achieved by the activity of CEH-20/Exd/Pbx, a known cofactor of Hox proteins. Unfused VPCs in lin-39(?);eff-1(?) double mutants fail to divide but migrate, executing vulval fates. Thus, lin-39 is essential for inhibition of EFF-1-dependent cell fusion and stimulation of cell proliferation during vulva formation. Supplemental material is available at http://www.genesdev.org. PMID:12502736

  18. Strongyloides myopotami (Secernentea: Strongyloididae) from the Intestine of Feral Nutrias (Myocastor coypus) in Korea

    PubMed Central

    Choe, Seongjun; Lee, Dongmin; Park, Hansol; Oh, Mihyeon; Jeon, Hyeong-Kyu

    2014-01-01

    Surveys on helminthic fauna of the nutria, Myocastor coypus, have seldom been performed in the Republic of Korea. In the present study, we describe Strongyloides myopotami (Secernentea: Strongyloididae) recovered from the small intestine of feral nutrias. Total 10 adult nutrias were captured in a wetland area in Gimhae-si (City), Gyeongsangnam-do (Province) in April 2013. They were transported to our laboratory, euthanized with ether, and necropsied. About 1,300 nematode specimens were recovered from 10 nutrias, and some of them were morphologically observed by light and scanning electron microscopies. They were 3.7-4.7 (4.0±0.36) mm in length, 0.03-0.04 (0.033) mm in width. The worm dimension and other morphological characters, including prominent lips of the vulva, blunted conical tail, straight type of the ovary, and 8-chambered stoma, were all consistent with S. myopotami. This nematode fauna is reported for the first time in Korea. PMID:25352703

  19. Strongyloides myopotami (Secernentea: Strongyloididae) from the intestine of feral nutrias (Myocastor coypus) in Korea.

    PubMed

    Choe, Seongjun; Lee, Dongmin; Park, Hansol; Oh, Mihyeon; Jeon, Hyeong-Kyu; Eom, Keeseon S

    2014-10-01

    Surveys on helminthic fauna of the nutria, Myocastor coypus, have seldom been performed in the Republic of Korea. In the present study, we describe Strongyloides myopotami (Secernentea: Strongyloididae) recovered from the small intestine of feral nutrias. Total 10 adult nutrias were captured in a wetland area in Gimhae-si (City), Gyeongsangnam-do (Province) in April 2013. They were transported to our laboratory, euthanized with ether, and necropsied. About 1,300 nematode specimens were recovered from 10 nutrias, and some of them were morphologically observed by light and scanning electron microscopies. They were 3.7-4.7 (4.0±0.36) mm in length, 0.03-0.04 (0.033) mm in width. The worm dimension and other morphological characters, including prominent lips of the vulva, blunted conical tail, straight type of the ovary, and 8-chambered stoma, were all consistent with S. myopotami. This nematode fauna is reported for the first time in Korea. PMID:25352703

  20. Hormone receptors in dystrophic and neoplastic vulvar disease. Preliminary considerations.

    PubMed

    Becagli, L; Scrimin, F; De Salvia, D; Gambato, M; Resta, P; Ambrosini, A

    1983-01-01

    Hormone receptor assays for testosterone, estrogens and androgens were performed on 53 biopsy specimens of vulva from 40 patients, consisting of 6 with normal tissue, 14 with atrophic type dystrophy, 13 with hypertrophic type dystrophy, and 20 with malignancy. Atrophic and hypertrophic forms showed a different receptor pattern; hypertrophic forms were characterized by consistently higher levels of progesterone receptors not correlated with estrogen receptors. Neoplastic tissue showed no significant changes in values compared to normal or dystrophic forms, but range of variability was high. The bond between neoplastic forms and hormone activity seems without doubt less important than in the corresponding endometrial and mammary forms. The study of dystrophic forms, instead, should be further explored with a larger number of cases. PMID:6313258

  1. The transcription factor VAB-23 links vulval cell fate specification and morphogenesis.

    PubMed

    Pellegrino, Mark W; Hajnal, Alex

    2012-07-01

    During organogenesis, individual cells must commit to and execute specific cell fates. However, the molecular mechanisms linking cell fate specification to fate execution and morphogenesis remain a largely unexplored area in developmental biology. The Caenorhabditis elegans vulva is an excellent model to dissect the molecular pathways linking cell fate specification and execution during organogenesis. We have recently identified a conserved nuclear zinc finger transcription factor called VAB-23 that plays essential roles during vulval torid formation in the larva and ventral epidermal closure in the embryo. VAB-23 regulates the transcription of specific target genes including smp-1 Semaphorin. EGFR/RAS/MAPK signaling upregulates via the HOX protein LIN-39 the expression of VAB-23 in the 1° vulval cell lineage, indicating that cell fate specification and execution are temporally overlapping and tightly linked processes. Here, we discuss the roles of VAB-23 in morphogenesis and the implications of its regulation on the spatio-temporal control of organogenesis. PMID:24058843

  2. Description of Thecavermiculatus andinus n.sp. (Meloidoderidae), a Round Cystoid Nematode from the Andes Mountains of Peru.

    PubMed

    Golden, A M; Franco, J; Jatala, P; Astogaza, E

    1983-07-01

    Thecavermiculatus andinus n.sp. is described and illustrated from Oxalis tuberosa originally collected in the vicinity of Lake Titicaca high in the Andes mountains of southern Peru. This new species differs markedly front the other two species in the genus, especially in having a much greater female vulval-anal distance and annules with lined punctation on most of the female body with a lacelike pattern restricted to the posterior portion, particularly at the vulva and anus which do not protrude. Females are essentially spherical with protruding neck, white to yellowish in color, and can easily be mistaken for potato cyst nematodes. Among the dozen or more known weed and crop host plants are potato and eggplant. In order to accommodate this new species, the genus Thecavermieulatus is emended. A key to the species of this genus is presented. PMID:19295818

  3. Description of Thecavermiculatus andinus n.sp. (Meloidoderidae), a Round Cystoid Nematode from the Andes Mountains of Peru

    PubMed Central

    Golden, A. M.; Franco, J.; Jatala, P.; Astogaza, E.

    1983-01-01

    Thecavermiculatus andinus n.sp. is described and illustrated from Oxalis tuberosa originally collected in the vicinity of Lake Titicaca high in the Andes mountains of southern Peru. This new species differs markedly front the other two species in the genus, especially in having a much greater female vulval-anal distance and annules with lined punctation on most of the female body with a lacelike pattern restricted to the posterior portion, particularly at the vulva and anus which do not protrude. Females are essentially spherical with protruding neck, white to yellowish in color, and can easily be mistaken for potato cyst nematodes. Among the dozen or more known weed and crop host plants are potato and eggplant. In order to accommodate this new species, the genus Thecavermieulatus is emended. A key to the species of this genus is presented. PMID:19295818

  4. [Natural infection of Speothos venaticus (Carnivora: Canidae) by adult stages of Lagochilascaris sp].

    PubMed

    Volcán, G S; Medrano, C E

    1991-01-01

    An adult male Speothos venaticus Lund (bush dog) was found killed on a rural road in the Northeast of Bolívar State, in a locality where a patient with lagochilascariasis has lived for the past 16 years. The animal was frozen for 1 month, and after removal of the head and skin, was autopsied. Two adult gravid females of Lagochilascaris sp. were found in the trachea. Certain morphological characteristics of the soft parts differed from the description given for Lagochilascaris minor Leiper, 1909; however, stable characters, such as the form of the interlabials, the location of the vulva, and particularly the size and number of depressions of the egg shell appear to indicate that the worms are of the above mentioned species. Unfortunately, no males were found for study of the spicules and ejaculatory duct. In histological sections of the larynx and the trachea from the deep tissues, parts of degenerated worms were found, with characteristics attributable to Lagochilascaris sp. PMID:1844975

  5. Description of two new species of Arcania Leach, 1817, from the western Pacific Ocean and redescriptions of A. undecimspinosa De Haan, 1841, and A. elongata Yokoya, 1933 (Crustacea: Brachyura: Leucosiidae).

    PubMed

    Naruse, Tohru

    2014-01-01

    Arcania undecimspinosa De Haan, 1841, and A. elongata Yokoya, 1933, are redescribed, with a lectotype of A. undecimspinosa formally designated. Redescription of the two species revealed that there are several specimens and possible undescribed species that have been inaccurately recorded under the name of A. undecimspinosa and A. elongata. Two such species are described from the western and southern Pacific Ocean as new to science. These four species partially overlap their geographical distributions and are superficially similar to each other, but the present study shows that there are clear differences in the shapes of their male first gonopods, female vulvae, frontal lobes of the carapace and other morphological characters. Literature that cited A. undecimspinosa s.l. is also reviewed to highlight possible taxonomic problems. PMID:24943431

  6. Pattern of loss of spermatozoa from the vagina of the ewe.

    PubMed

    Tilbrook, A J; Pearce, D T

    1986-01-01

    In a series of experiments spermatozoa were inseminated blindly into the vagina of ewes and then recovered at varying times after insemination. Most of the spermatozoa inseminated were lost by drainage through the vulva. The rate of loss was not affected by the motility of spermatozoa or oestrous state of the ewe. Initially after insemination the loss was not rapid with 82% of the insemination 18% of spermatozoa remained and by 12 h 10% remained. Spermatozoa were removed from the vagina during withdrawal of the penis after intromission and the extent of this loss varied between rams and with the volume of semen already in the vagina. Up to half the inseminate was lost in this way when there was 0.5 ml of semen in the vagina but only 11% was lost when the volume of inseminate was 0.1 ml. The unavoidable loss of spermatozoa may influence the quantity available for fertilizing ova. PMID:3827743

  7. Verruciform xanthoma in the setting of cutaneous trauma and chronic inflammation: report of a patient and a brief review of the literature.

    PubMed

    Cumberland, Lara; Dana, Ali; Resh, Brooke; Fitzpatrick, James; Goldenberg, Gary

    2010-08-01

    We report a rare case of multiple, co-exisitng verruciform xanthomas (VXs) of the anogenital region in the setting of cutaneous trauma. VX is a rare benign mucocutaneous neoplasm that typically presents as a solitary lesion with a predilection for the oral cavity, although extra-oral lesions have been reported involving the vulva, scrotum, penis, anal region and extremities. The etiology and pathogenesis of VX have yet to be determined; however, recent literature has reported that multifocal cutaneous VX are frequently associated with pre-existing inflammatory processes. A significant number of VXs of the skin have been found to co-exist with cutaneous disorders including graft vs. host disease, discoid lupus erythematosus, pemphigus vulgaris, and recessive dystrophic epidermolysis bullosa. Therefore, we speculate severe cutaneous trauma and chronic inflammation may induce epithelial keratinocytes to respond aberrantly leading to epidermal hyperplasia and foamy cell formation characterizing the VX lesion. PMID:19958440

  8. HPV-associated diseases.

    PubMed

    Ljubojevic, Suzana; Skerlev, Mihael

    2014-01-01

    Nearly 200 distinct human papilloma viruses (HPVs) have now been recognized, and each is associated with a specific set of clinical lesions. They are associated with a spectrum of diseases, from benign verrucae vulgares and condylomata acuminata to the malignancies of the cervix, vulva, anus, and penis. Disease associated with HPV can be divided into skin and mucosal lesion of the genital and extragenital regions. The relationship between HPV and nonmelanoma skin cancer (NMSC) is important clinically, because NMSC is the most common form of malignancy among fair-skinned populations. HPVs have also been detected in skin tags, lichen sclerosus, seborrheic keratoses, actinic keratoses, epidermal cysts, psoriatic plaques, and plucked hairs, but cutaneous HPV can be found on healthy skin. PMID:24559558

  9. Planar polarity genes and inhibition of supernumerary neurites.

    PubMed

    Colavita, Antonio

    2012-04-01

    Planar cell polarity (PCP) genes have recently emerged as important players in sculpting neuronal connections. The bipolar VC neurons display stereotypical differences in axon extension along the anterior-posterior (AP) body axis: VC1-3 and VC6 polarize along the AP axis while VC4 and VC5 polarize along the orthogonal left-right (LR) axis generated by the developing vulva. vang-1 and prkl-1, the worm orthologs of Van Gogh and Prickle, are required to restrict the polarity of neurite emergence to a specific tissue axis. vang-1 and prkl-1 loss results in ectopic VC4 and VC5 neurites extending inappropriately along the AP axis. Conversely, prkl-1 overexpression in VC neurons suppresses neurite formation. These findings suggest that a PCP-like pathway acts to silence or antagonize neuronal responses to polarity cues that would otherwise be permissive for neurite growth. PMID:24058835

  10. Pruritus in female patients.

    PubMed

    Lambert, Julien

    2014-01-01

    Pruritus is a frequent symptom in many dermatological diseases. In this review we want to focus on not only itch problems specific to women, namely, pruritic vulvodermatoses, but also the specific pruritic dermatoses of pregnancy. The specific characteristics of the vulva and the hormonal changes during the different age periods make these dermatoses very particular. It seems that vulvar diseases are still underdiagnosed and undertreated. Pruritic vulvar diseases have a huge impact on quality of life. The most common pruritic diseases will be discussed, such as atopic and contact dermatitis, psoriasis, lichen sclerosis, lichen planus, and infectious vulvaginitis. We focus on the diagnostic issue of these diseases and will consider the general principles of therapy. PMID:24711996

  11. In Vivo Imaging of Caenorhabditis elegans Glycans

    PubMed Central

    2009-01-01

    The nematode Caenorhabditis elegans is an excellent model organism for studies of glycan dynamics, a goal that requires tools for imaging glycans in vivo. Here we applied the bioorthogonal chemical reporter technique for the molecular imaging of mucin-type O-glycans in live C. elegans. We treated worms with azidosugar variants of N-acetylglucosamine (GlcNAc), N-acetylgalactosamine (GalNAc), and N-acetylmannosamine (ManNAc), resulting in the metabolic labeling of their cell-surface glycans with azides. Subsequently, the worms were reacted via copper-free click reaction with fluorophore-conjugated difluorinated cyclooctyne (DIFO) reagents. We identified prominent localization of mucins in the pharynx of all four larval stages, in the adult hermaphrodite pharynx, vulva and anus, and in the tail of the adult male. Using a multicolor, time-resolved imaging strategy, we found that the distribution and dynamics of the glycans varied anatomically and with respect to developmental stage. PMID:19954190

  12. Monitoring of human papillomavirus vaccination.

    PubMed

    Dillner, J; Arbyn, M; Unger, E; Dillner, L

    2011-01-01

    Persistent infection with oncogenic human papillomavirus (HPV) is a necessary causal factor in the development of cervical cancer. Moreover, HPV, predominately type 16 and to a lesser degree type 18, is linked causally to varying proportions of other anogenital cancers (vulva, vagina, penis, anus) as well as cancers elsewhere in the body (oropharynx, larynx, conjunctiva). HPV types 6 and 11 cause most of genital warts and recurrent respiratory papillomatosis. Effective prophylactic vaccines have been developed. In this review, we address briefly the immunological aspects of HPV infection and the results of HPV vaccination trials. Internationally standardized monitoring and evaluation of prophylactic HPV vaccination programmes will be essential for arriving at the most cost-effective strategies for cancer control. PMID:21062269

  13. Ochoterenella esslingeri n. sp. (Nematoda: Onchocercidae: Waltonellinae) from Bokermannohyla luctuosa (Anura: Hylidae) in Minas Gerais, Brazil, with notes on Paraochoterenella Purnomo & Bangs, 1999

    PubMed Central

    Souza Lima, S.; Marun, B.; Alves, P.V.; Bain, O.

    2012-01-01

    The waltonelline Ochoterenella esslingeri n. sp., a filarial parasite of the anuran Bokermannohyla luctuosa in Minas Gerais, Brazil is described. Several characters distinguish this new species from the 15 species presently included in the genus: the cuticular ornamentation of the female that is restricted to the posterior region of the body, the irregular arrangement of the small, rounded bosses, the postoesophageal vulva, the short glandular oesophagus, the size and shape of the microfilariae, the long left spicule and high spicular ratio. Irregularly arranged, tiny, rounded bosses are common in the monotypic genus Paraochoterenella from an Indonesian ranid, which is not well defined but likely valid. In the Neotropical Realm, the type hosts of the species of Ochoterenella are Hylidae (O. esslingeri n. sp.), Leptodactylidae (two species) and the remaining 13 species were described from the giant toad Rhinella marina (Bufonidae). PMID:23193518

  14. Late injury of cancer therapy on the female reproductive tract

    SciTech Connect

    Grigsby, P.W. [Washington Univ. School of Medicine, St. FLouis, MO (United States)] [Washington Univ. School of Medicine, St. FLouis, MO (United States); Russell, A. [Radiological Associates, Sacramento, CA (United States)] [Radiological Associates, Sacramento, CA (United States); Bruner, D. [Fox Chase Cancer Center, Philadelphia, PA (United States)] [and others] [Fox Chase Cancer Center, Philadelphia, PA (United States); and others

    1995-03-30

    The purpose of this article is to review the late effects of cancer therapy on the female reproductive tract. The anatomic sites detailed are the vulva, vagina, cervix, uterus, fallopian tubes, and ovaries. The available pathophysiology is discussed. Clinical syndromes are presented. Tolerance doses of irradiation for late effects are rarely presented in the literature and are reviewed where available. Management strategies for surgical, radiotherapeutic, and chemotherapeutic late effects are discussed. Endpoints for evaluation of therapeutic late effects have been formulated utilizing the symptons, objective, management, and analytic (SOMA) format. Late effects on the female reproductive tract from cancer therapy should be recognized and managed appropriately. A grading system for these effects is presented. Endpoints for late effects and tolls for the evaluation need to be further developed. 61 refs., 9 figs., 13 tabs.

  15. Litomosoides (Nemata: Filarioidea) of bats from Bolivia with records for three known species and the description of a new species.

    PubMed

    Notarnicola, Juliana; Ruíz, F Agustín Jiménez; Gardner, Scott L

    2010-08-01

    Herein, we describe Litomosoides salazari n. sp. collected from the body cavity of the yellow bat, Lasiurus ega , from Bolivia. This new species of filarioid nematode is most closely related to the carinii group and is characterized by its relatively small size with the vulva located slightly posterior to the esophago-intestinal junction; an arrow-shaped buccal capsule; and a short, rounded tail. New host and locality records for both Litomosoides hamletti and L. chandleri in phyllostomid bats, and L. brasiliensis occurring in both phyllostomid and vespertilionid bats, are provided. The morphological variability of the specimens is documented by providing comparative measurements of 3 known species. Litomosoides brasiliensis occurs in 6 species of bats from Bolivia and was the most common species of filarioid nematode encountered. All 4 species of nematodes, including the new species, were found in sympatry at Chijchijpa, a locality in the Yungas of Bolivia. PMID:20738202

  16. A new ladybird spider from Hungary (Araneae, Eresidae)

    PubMed Central

    Kovács, Gábor; Prazsák, István; Eichardt, János; Vári, Gábor; Gyurkovics, Henrik

    2015-01-01

    Abstract According to the most recent taxonomic literature, three species of the genus Eresus are known in Central Europe, Eresus kollari, Eresus sandaliatus and Eresus moravicus. We recognized a fourth distinctive species from Hungary, which is described as Eresus hermani sp. n. Eresus hermani has an early spring copulation period, females have a light grey (grizzled) cephalothorax due to a heavy cover of lightly colored setae, and an epigyne with large flat areas posterior to the epigynal pit, while males are distinguished by a broad and blunt terminal tooth of the conductor. An updated and modified comparative table of ?ezá? et al. (2008) to include all four Central European Eresus species, and a simple key to the species group’s species are given. Habitus, epigyne, vulva and conductor of Eresus kollari, Eresus moravicus and Eresus sandaliatus are also illustrated. An annotated list of papers illustrating Eresus hermani due to misidentifications is presented. PMID:25901112

  17. Oral therapy for Pruritus Ani

    Microsoft Academic Search

    Laurence Griffin Bodkin

    1945-01-01

    Summary  \\u000a \\u000a \\u000a \\u000a 1. \\u000a \\u000a 42 Cases of Pruritus Ani were treated, with oral medication and local applications.\\u000a \\u000a \\u000a \\u000a \\u000a 2. \\u000a \\u000a History of the duration of symptoms varied from 1 to 30 years. Three cases also had Pruritus Vulvae.\\u000a \\u000a \\u000a \\u000a \\u000a 3. \\u000a \\u000a A formula containing Takadiastase and Sodium Dilantin made an effective combination. Dilantin alone did not control the condition.\\u000a \\u000a \\u000a \\u000a \\u000a 4. \\u000a \\u000a Soap and water are avoided at

  18. [Multifocal mycoses in women: prevalence, species characteristics, and some intraspecific features].

    PubMed

    Mamos, Aneta Renata; Kurnatowska, Alicja

    2004-01-01

    The aim of this study was to detect fungi in three ontocenoses of 947 women (aged 20-45). The prevalence of multifocal fungal infections in women varied from 62.2 +/- 2.99% to 81.0 +/- 3.92% in different ontocenoses. They assumed the following mean values: 38.4 +/- 1.77% for the vagina, 42.2 +/- 1.80% for the oral cavity, and 25.0 +/- 1.58% for the anus. The clinical manifestations of sexual organs inflammations were statistically significantly (p < 0.01) more frequent in women infected with fungi than in those without fungi in the vaginal ontocenosis. The highest convergence of the fungi presence with subjective and objective symptoms (assessed using the Yule Q index value) concerned: pruritus of the vulva or/and vaginal walls, burning sensation or painful urethra, as well as oedema of the external opening of the urethra, vulva or/and the vagina (Q from +0.808 to +0.970). However, there was no statistically significant convergence between occurrence of the fungi and vaginal discharge and painful hypogastrium. Based on more than 40 phenotypical features (morphological, biochemical) of the axenic strains originating from vaginal, oral, and anal ontocenoses, a total of 12 species of fungi were identified: Candida albicans, C. guilliermondii, C. krusei, C. tropicalis, C. kefyr, C. utilis, C. humicola, C. viswanathii, C. glabrata, C. parapsilosis, Rhodotorula mucilaginosa, and Geotrichum candidum. For intraspecific features, depending on the profile of the compounds used for auxanogram, 9 codes were read for Candida albicans and only one code for each of other species was detected. In API ZYM test based on assessment of 19 hydrolase activities the enzymograms of species included from 6 to 11 enzymes. PMID:16865940

  19. Unusual remodeling of the hyalinization band in vulval lichen sclerosus by type V collagen and ECM 1 protein

    PubMed Central

    Godoy, Charles A.P.; Teodoro, Walcy R.; Velosa, Ana Paula P.; Garippo, Ana Lucia; Eher, Esmeralda Miristeni; Parra, Edwin Roger; Sotto, Mirian N.; Capelozzi, Vera L.

    2015-01-01

    OBJECTIVES: The vulva is the primary site affected in lichen sclerosus, a chronic dermatosis in women that is histologically characterized by a zone of collagen remodeling in the superior dermis. The normal physiological properties of the vulva depend on the assembly of collagen types I (COLI), III (COLIII) and V (COLV), which form heterotypic fibers, and extracellular matrix protein interactions. COLV regulates the heterotypic fiber diameter, and the preservation of its properties is important for maintaining normal tissue architecture and function. In the current work, we analyzed the expression of COLV and its relationship with COLI, COLIII, elastic fibers and extracellular matrix protein 1 in vulvar biopsies from patients with lichen sclerosus. METHODS: Skin biopsies from 21 patients with lichen sclerosus, classified according to Hewitt histological criteria, were studied and compared to clinically normal vulvar tissue (N=21). Morphology, immunohistochemistry, immunofluorescence, 3D reconstruction and morphometric analysis of COLI, COLIII, COLV deposition, elastic fibers and extracellular matrix 1 expression in a zone of collagen remodeling in the superior dermis were performed. RESULTS: A significant decrease of elastic fibers and extracellular matrix 1 protein was present in the hyalinization zone of lichen sclerosus compared to healthy controls. The non-homogeneous distribution of collagen fibers visualized under immunofluorescence in the hyalinization zone of lichen sclerosus and control skin was confirmed by histomorphometry. Lichen sclerosus dermis shows a significant increase of COLI, COLIII and COLV expression compared to the healthy controls. Significant inverse associations were found between elastic fibers and COLV and between COLV and extracellular matrix 1 expression. A direct association was found between elastic fiber content and extracellular matrix 1 expression. Tridimensional reconstruction of the heterotypic fibers of the lichen sclerosus zone of collagen remodeling confirmed the presence of densely clustered COLV. CONCLUSIONS: Increased deposition of abnormal COLV and its correlation with extracellular matrix 1 and elastic fibers suggest that COLV may be a trigger in the pathogenesis of lichen sclerosus. PMID:26039953

  20. Wnt and EGF pathways act together to induce C. elegans male hook development

    PubMed Central

    Yu, Hui; Seah, Adeline; Herman, Michael A.; Ferguson, Edwin L.; Horvitz, H. Robert; Sternberg, Paul W.

    2009-01-01

    Comparative studies of vulva development between Caenorhabditis elegans and other nematode species have provided some insight into the evolution of patterning networks. However, molecular genetic details are available only in C. elegans and Pristionchus pacificus. To extend our knowledge on the evolution of patterning networks, we studied the C. elegans male hook competence group (HCG), an equivalence group that has similar developmental origins to the vulval precursor cells (VPCs), which generate the vulva in the hermaphrodite. Similar to VPC fate specification, each HCG cell adopts one of three fates (1°, 2°, 3°), and 2°HCG fate specification is mediated by LIN-12/Notch. We show that 2° HCG specification depends on the presence of a cell with the 1° fate. We also provide evidence that Wnt signaling via the Frizzled-like Wnt receptor LIN-17 act to specify the 1° and 2° HCG fate. A requirement for EGF signaling during 1° fate specification is seen only when LIN-17 activity is compromised. In addition, activation of the EGF pathway decreases dependence on LIN-17 and causes ectopic hook development. Our results suggest that WNT plays a more significant role than EGF signaling in specifying HCG fates, whereas in VPC specification EGF signaling is the major inductive signal. Nonetheless, the overall logic is similar in the VPCs and the HCG: EGF and/or WNT induce a 1° lineage, and LIN-12/NOTCH induces a 2° lineage. Wnt signaling is also required for execution of the 1° and 2°HCG lineages. lin-17 and bar-1/?-catenin are preferentially expressed in the presumptive 1° cell P11.p. The dynamic subcellular localization of BAR-1–GFP in P11.p is concordant with the timing of HCG fate determination. PMID:19154732

  1. Diffuse idiopathic calcinosis cutis in an adult: a rare case.

    PubMed

    Prabhu, Raghunath; Sarma, Yashdeep Sinha; Phillip, Karan; Sadhu, Sakshi

    2014-06-01

    Idiopathic calcinosis cutis is a condition involving the deposition of calcium salts in the skin and subcutaneous tissue. The disease is a pathological condition of unknown origin and hence is idiopathic. The salt deposition is confined to areas such as the breast and vulva in females and scrotum and penis in males. Diffuse calcification with multiple complications in an adult is a rare entity. Only one such case has been reported in literature. A 59-year-old female presented to us with swelling of the right elbow, multiple calcific nodular lesions all over her fingers approximately 0.5x0.5 cm in size, and ulcers on her left great toe and right thumb with pain for the past two months. The ulcers were 2x2 cm and were observed to be healing without active discharge or signs of inflammation. The elbow was diffusely swollen and tender. Flexion deformity was present at the elbow. X-ray of hand and feet revealed calcinosis of the elbow and interphalangeal joints of the foot and hand. Blood tests revealed elevated C-reactive protein levels of 24 mg/dL, elevated Erythrocyte Sedimentation Rate (ESR) of 52 mm/hr., serum calcium of 9.7 mg/dL and a serum phosphorous of 5 mg/dL. Cultures from the foot ulcer were positive for methicillin-resistant staphylococcus aureus (MRSA). Workup for collagen vascular disease was negative. Histopathology confirmed calcinosis cutis. Treatment involved a conservative approach, including physiotherapy for the flexion deformity, antibiotics for MRSA, analgesics for pain relief and daily dressings. This case demonstrates that if a patient presents with multiple chalky nodular lesions with or without ulceration, pain and discharge involving areas of the upper limb or lower limb, diagnosis of idiopathic calcinosis cutis could be considered as a differential, despite its common confinement to the scrotum, breast, vulva and penis. PMID:25610312

  2. Necrotizing Fasciitis: A Review of Management Guidelines in a Large Obstetrics and Gynecology Teaching Hospital

    PubMed Central

    Thompson, C. D.; Brekken, A. L.

    1993-01-01

    Necrotizing fasciitis is a severe, life-threatening soft tissue infection that results in rapid and progressive destruction of the superficial fascia and subcutaneous tissue. Because of its varied clinical presentation and bacteriological make-up, it has been labelled with many other names such as acute streptococcal gangrene, gangrenous erysipelas, necrotizing erysipelas, hospital gangrene, and acute dermal gangrene. Although described by Hippocrates and Galen, it has received increasing attention in obstetrical and gynecological literature only within the last 20 years. This review includes two recent cases successfully managed at Parkland Memorial Hospital, Dallas, Texas. The first patient was a 50 year old, morbidly obese, diabetic woman who presented with a small, painful lesion on the vulva. After failing triple antibiotic therapy with ampicillin, clindamycin, and gentamicin, the diagnosis of necrotizing fasciitis of the vulva was made, and she was taken to the operating room for extensive excision. She was discharged home on hospital day 29. The second patient was a 65 year old, obese, diabetic woman with risk factors for atherosclerosis who had a wound separation after an abdominal hysterectomy. Two days later a loss of resistance to probing was noted in the subcutaneous tissue. Necrotizing fasciitis was suspected, and she was taken to the operating room for resection. The patient was discharged home on hospital day 27. The mortality rate after diagnosis of necrotizing fasciitis has been reported to be 30% to 60%. We review the literature and outline the guidelines used in a large Ob/Gyn teaching hospital to minimize the adverse outcome. Lectures on soft-tissue infections are included on a regular basis. The high-risk factors of age over 50, diabetes, and atherosclerosis are emphasized. The need for early diagnosis and surgical treatment within 48 hours is stressed, and any suspicious lesions or wound complications are reported to experienced senior house officers and staff. We use two recent cases to highlight the diagnostic clues and management strategies for this often fatal polymicrobial infection. PMID:18476200

  3. Diffuse Idiopathic Calcinosis Cutis in an Adult: A Rare Case

    PubMed Central

    Prabhu, Raghunath; Sarma, Yashdeep Sinha; Phillip, Karan; Sadhu, Sakshi

    2014-01-01

    Idiopathic calcinosis cutis is a condition involving the deposition of calcium salts in the skin and subcutaneous tissue. The disease is a pathological condition of unknown origin and hence is idiopathic. The salt deposition is confined to areas such as the breast and vulva in females and scrotum and penis in males. Diffuse calcification with multiple complications in an adult is a rare entity. Only one such case has been reported in literature. A 59-year-old female presented to us with swelling of the right elbow, multiple calcific nodular lesions all over her fingers approximately 0.5x0.5 cm in size, and ulcers on her left great toe and right thumb with pain for the past two months. The ulcers were 2x2 cm and were observed to be healing without active discharge or signs of inflammation. The elbow was diffusely swollen and tender. Flexion deformity was present at the elbow. X-ray of hand and feet revealed calcinosis of the elbow and interphalangeal joints of the foot and hand. Blood tests revealed elevated C-reactive protein levels of 24 mg/dL, elevated Erythrocyte Sedimentation Rate (ESR) of 52 mm/hr., serum calcium of 9.7 mg/dL and a serum phosphorous of 5 mg/dL. Cultures from the foot ulcer were positive for methicillin-resistant staphylococcus aureus (MRSA). Workup for collagen vascular disease was negative. Histopathology confirmed calcinosis cutis. Treatment involved a conservative approach, including physiotherapy for the flexion deformity, antibiotics for MRSA, analgesics for pain relief and daily dressings. This case demonstrates that if a patient presents with multiple chalky nodular lesions with or without ulceration, pain and discharge involving areas of the upper limb or lower limb, diagnosis of idiopathic calcinosis cutis could be considered as a differential, despite its common confinement to the scrotum, breast, vulva and penis. PMID:25610312

  4. Morphology and function of the reproductive system of representatives of the genus Uca.

    PubMed

    Lautenschlager, Agnes D; Brandis, Dirk; Storch, Volker

    2010-11-01

    The morphology of the reproductive organs of three species of fiddler crabs, Uca ecuadoriensis, Uca c.f. forcipata, and Uca tangeri were investigated to subsequently produce a model of their mode of operation. Vulva, vagina, and spermatheca in females, and the first and second gonopods in males were examined by applying histological techniques and electron microscopy. In all three species, vulva and vagina conform to the concave type, and the spermatheca complies with the ventral type. The tissue of the oviduct orifice is enlarged and bulges into the lumen of the spermatheca. Differences between the three species are apparent in the organization of the spermatheca, especially in the distribution and structure of glandular epithelium: In U. ecuadoriensis and U. c.f. forcipata the largest proportion of the spermathecal wall is lined with cuticle and only a small area consists of glandular epithelium, while in U. tangeri almost all of the lining is glandular. Furthermore, the glandular epithelia of the species differ in their histology and ultrastructure: In U. ecuadoriensis it is tubular and multilayered, while in U. c.f. forcipata it is mono-layered. U. tangeri finally has both forms of this tissue. In the males, the terminal segments of the first gonopod exhibit a tight fit to female organs and narrow, tightly sealed sperm channels. These features suggest a tendency towards minimizing loss of fluids, which can be interpreted as an adaptation to mating on land. The tight fit of male gonopod and female opening seem to be protection from interbreeding, which points toward a strong sexual selection. In the terrestrial environment, these originally aquatic organisms experience serious competition for resources; therefore there is pressure on successful reproduction. According to the current results a model of the process of fertilization and egg-laying involving the investigated organs was generated. PMID:20665534

  5. A clinically oriented perspective on psychogenic nonepileptic seizure-related emergencies.

    PubMed

    Dworetzky, Barbara A; Weisholtz, Daniel S; Perez, David L; Baslet, Gaston

    2015-01-01

    Psychogenic nonepileptic seizures (PNES) can present emergently and are often mistaken for epileptic seizures. PNES emergencies have not been well studied, and yet there are associated serious morbidities, particularly when patients are seen in an emergency setting and are misdiagnosed. PNES may be prolonged, mimicking status epilepticus, a condition we refer to as nonepileptic psychogenic status (NEPS), and patients may receive aggressive and unnecessary medical treatments that can lead to serious iatrogenic complications, including death. NEPS is also associated with an increased risk of self-harm, including suicide attempts, and may indicate a serious comorbid psychiatric illness. In addition to iatrogenic complications of PNES, accidents and injuries are an underrecognized source of morbidity. PNES may also present during medical procedures, which may not only interfere with their completion, but may alarm practitioners who, fearing liability, may initiate further medical evaluations and treatments. When PNES occur during pregnancy, patients may be misdiagnosed with eclampsia and their offspring delivered prematurely. They also risk being placed on medications that are harmful to the fetus. Increased awareness of PNES is necessary to prevent iatrogenic harm and to identify underlying psychiatric illnesses that carry their own risks. As yet, data available to guide treatment are scant, and further study is needed. PMID:25780265

  6. Tracking a medically important spider: climate change, ecological niche modeling, and the brown recluse (Loxosceles reclusa).

    PubMed

    Saupe, Erin E; Papes, Monica; Selden, Paul A; Vetter, Richard S

    2011-01-01

    Most spiders use venom to paralyze their prey and are commonly feared for their potential to cause injury to humans. In North America, one species in particular, Loxosceles reclusa (brown recluse spider, Sicariidae), causes the majority of necrotic wounds induced by the Araneae. However, its distributional limitations are poorly understood and, as a result, medical professionals routinely misdiagnose brown recluse bites outside endemic areas, confusing putative spider bites for other serious conditions. To address the issue of brown recluse distribution, we employ ecological niche modeling to investigate the present and future distributional potential of this species. We delineate range boundaries and demonstrate that under future climate change scenarios, the spider's distribution may expand northward, invading previously unaffected regions of the USA. At present, the spider's range is centered in the USA, from Kansas east to Kentucky and from southern Iowa south to Louisiana. Newly influenced areas may include parts of Nebraska, Minnesota, Wisconsin, Michigan, South Dakota, Ohio, and Pennsylvania. These results illustrate a potential negative consequence of climate change on humans and will aid medical professionals in proper bite identification/treatment, potentially reducing bite misdiagnoses. PMID:21464985

  7. Giant retroperitoneal bronchogenic cyst mimicking a cystic teratoma: A case report

    PubMed Central

    TONG, HAN-XING; LIU, WEN-SHUAI; JIANG, YING; LIU, JU; ZHOU, JIAN-JUN; ZHANG, YONG; LU, WEI-QI

    2015-01-01

    Retroperitoneal bronchogenic cysts (RBCs) are regarded as a rare type of congenital dysplasia disease that stems from the primitive foregut. Thus far, the exact pathogenesis of RBCs remains unknown. Due to an atypical clinical manifestation, RBCs are often incidentally detected and diagnosed by imaging modalities, such as computed tomography and magnetic resonance imaging. However, they are easily misdiagnosed due to their non-specific imaging features. Additionally, the most appropriate treatment strategy for an RBC is considered to be surgical resection. The present study reports the rare case of a 36-year-old female with a large RBC containing fatty fluid that was previously misdiagnosed as liposarcoma or cystic teratoma. Following a complex surgical resection, pathological findings confirmed a diagnosis of RBC. The follow-up examination showed that the patient was in good health at 16 months post-surgery, with no evidence of recurrence. Although rare, bronchogenic cysts must be considered in the differential diagnosis of retroperitoneal teratoma, and surgical resection should be pursued for symptom resolution and to establish a definitive histology.

  8. Improving the Performance of the Structure-Based Connectionist Network for Diagnosis of Helicopter Gearboxes

    NASA Technical Reports Server (NTRS)

    Jammu, Vinay B.; Danai, Koroush; Lewicki, David G.

    1996-01-01

    A diagnostic method is introduced for helicopter gearboxes that uses knowledge of the gear-box structure and characteristics of the 'features' of vibration to define the influences of faults on features. The 'structural influences' in this method are defined based on the root mean square value of vibration obtained from a simplified lumped-mass model of the gearbox. The structural influences are then converted to fuzzy variables, to account for the approximate nature of the lumped-mass model, and used as the weights of a connectionist network. Diagnosis in this Structure-Based Connectionist Network (SBCN) is performed by propagating the abnormal vibration features through the weights of SBCN to obtain fault possibility values for each component in the gearbox. Upon occurrence of misdiagnoses, the SBCN also has the ability to improve its diagnostic performance. For this, a supervised training method is presented which adapts the weights of SBCN to minimize the number of misdiagnoses. For experimental evaluation of the SBCN, vibration data from a OH-58A helicopter gearbox collected at NASA Lewis Research Center is used. Diagnostic results indicate that the SBCN is able to diagnose about 80% of the faults without training, and is able to improve its performance to nearly 100% after training.

  9. A patient with atonic seizures mimicking transient ischemic attacks?

    PubMed Central

    Kang, Min-Ju; Choi, Jun Young; An, Young-Sil; Park, Ki-Hyung; Park, Hyeon-Mi; Lee, Yeong-Bae; Shin, Dong-Jin; Sung, Young Hee; Shin, Dong Hoon

    2015-01-01

    A focal atonic seizure is a partial seizure in which the ictal manifestation consists of paresis of the extremities or muscles on one side of the body, and this phenomenon can easily be misdiagnosed as a transient ischemic attack. An 86-year-old woman visited our hospital complaining of transient right upper extremity weakness lasting for 10 min following an unusual sensation in her chest accompanied by palpitations. On the third hospital day, she again complained of right arm weakness, which progressed to jerky movements of her right extremity accompanied by facial twitching and then generalized into a tonic–clonic seizure. The EEG displayed several interictal spikes in the contralateral temporal area, and the ictal SPECT, analyzed using the SISCOM system, showed an increased signal in both the contralateral superior parietal area and the mesial frontal area. In this case, the patient was diagnosed with focal atonic seizures as the cause of the monolimb weakness, which had been initially misdiagnosed aas transient ischemic attacks. In cases in which a patient presents with monolimb paresis, physicians should consider the possibility of an atonic seizure as the cause. PMID:25870790

  10. Fecal microbiota transplantation and prednisone for severe eosinophilic gastroenteritis

    PubMed Central

    Dai, Yi-Xuan; Shi, Chuan-Bing; Cui, Bo-Ta; Wang, Min; Ji, Guo-Zhong; Zhang, Fa-Ming

    2014-01-01

    Eosinophilic gastroenteritis is a rare disease of unknown etiology. It is characterized by patchy or diffuse eosinophilic infiltration of the bowel wall to a variable depth and various gastrointestinal manifestations. We describe a case of severe eosinophilic gastroenteritis presenting as frequent bowel obstruction and diarrhea in a 35-year-old man. The patient was misdiagnosed and underwent surgery because of intestinal obstruction when he was first admitted to a local hospital. Then he was misdiagnosed as having Crohn’s disease in another university teaching hospital. Finally, the patient asked for further treatment from our hospital because of the on-going clinical trial for treating refractory Crohn’s disease by fecal microbiota transplantation. Physical examination revealed a slight distended abdomen with diffuse tenderness. Laboratory investigation showed the total number of normal leukocytes with neutrophilia as 90.5%, as well as eosinopenia, monocytopenia and lymphocytopenia. Barium radiography and sigmoidoscopy confirmed inflammatory stenosis of the sigmoid colon. We diagnosed the patient as having eosinophilic gastroenteritis by multi-examinations. The patient was treated by fecal microbiota transplantation combined with oral prednisone, and was free from gastrointestinal symptoms at the time when we reported his disease. This case highlights the importance of awareness of manifestations of a rare disease like eosinophilic gastroenteritis. PMID:25473198

  11. Chronic Thromboembolic Pulmonary Hypertension: Do not Miss the Chance for an Early Diagnosis

    PubMed Central

    Bagalas, Vasilis; Paspala, Asimina; Sourla, Evdokia; Akritidou, Sofia; Tsiolakidou, Katerina; Boutou, Afroditi; Pitsis, Antonis A.; Manika, Katerina; Kioumis, Ioannis P.; Stanopoulos, Ioannis; Pitsiou, Georgia

    2014-01-01

    Patient: Female, 45 Final Diagnosis: Chronic thromboembolic pulmonary hypertension (CTEPH) Symptoms: Dyspnea • fatigue • palpitations Medication: — Clinical Procedure: Right heart catheterization • pulmonary endarterectomy Specialty: Pulmonology Objective: Mistake in diagnosis Background: Chronic thromboembolic pulmonary hypertension most often results from obstruction of the pulmonary vascular bed by nonresolving thromboemboli. Misdiagnosis of the disease is common because patients often present with subtle or nonspecific symptoms. Furthermore, some features in chest imaging may mimic parenchymal lung disease. The most clinically important mimic in high-resolution chest tomography is air trapping, which can be seen in a variety of small airway diseases. Case Report: We present the case of a 45-year-old woman with a long history of dyspnea and exercise intolerance, misdiagnosed with allergic alveolitis. The diagnosis of CTEPH was finally established with computed tomography (CT) angiography and hemodynamics. Conclusions: Chronic thromboembolism is under-diagnosed and also frequently misdiagnosed in clinical practice. The present report aims to increase the awareness of clinicians towards an accurate diagnosis of the disease, which is necessary for the early referral of CTEPH patients for operability. PMID:25203436

  12. Clinical analysis of 15 patients with relapsing auricular polychondritis.

    PubMed

    Yang, Huang; Peng, Li; Jian, Mei; Qin, Li

    2014-03-01

    Relapsing polychondritis (RP) is a rare autoimmune disorder of unknown etiology. The disease is characterized by episodic inflammation and destruction of cartilaginous and connective tissue structures, including the ear, eye, nose, larynx, trachea, bronchi, joints, skin, heart valves, and aorta. As the symptoms of RP are diverse and complex, it is easily misdiagnosed. The aim of this paper was to improve the understanding of the clinical features of RP, thereby facilitating its early diagnosis. Fifteen patients with RP were analyzed retrospectively and the relevant literature reviewed. The number of patients presenting with auricular chondritis was 13, while two presented with polyarthritis. Among them, the treatment of 2 RP patients with respiratory tract involvement failed and 1 patient died. Eleven patients with RP (73 %) were initially misdiagnosed. RP involves cartilage and connective tissue. The prognosis for patients with respiratory tract involvement is poor. RP causes episodic and progressive inflammation of cartilage throughout the body and is associated with a variety of clinical manifestations. Early diagnosis of RP depends on a thorough understanding of its clinical features. PMID:23503986

  13. Giant Pulmonary Hydatid Cyst and Trauma in a 9 Year-Old Child: A Case Report.

    PubMed

    Sokouti, Mohsen; Shokouhi, Behrooz; Sokouti, Massoud; Sokouti, Babak

    2015-01-01

    Herein, we report a case of giant lung hydatid cyst in a nine-year-old boy. For four years, he experienced mild chest pain and chronic nonproductive cough. He had a trauma resulted from a fall two days before admission. Chest X-ray showed misdiagnosed massive pleural effusion, and was aspirated in the other hospital. However, after admission, the computed tomography revealed a giant lung hydatid cyst filling the right hemithorax completely. Being considered by the diagnosis of ruptured lung hydatid cyst, he was treated surgically by right-thoracotomy. The existing hydatid cyst, (e.g., with a dimension of 30*22*20cm) filled all cavity of hemithorax extended from the right diaphragm to the apex of the lung situated in the right lower lobe. After evacuation of the hydatid fluid and laminated membrane, right lower lobectomy was carried out due to remaining no salvageable parenchyma without any complications. Also, the pathologic examination have confirmed hydatid cyst. In conclusion, giant hydatid cysts are probably misdiagnosed with massive pleural effusion in the endemic area. And, because of the risk of allergic reactions, anaphylactic shock and dissemination, it should not be aspirated. PMID:26089993

  14. The diagnostic protocol for evaluation of periprosthetic joint infection.

    PubMed

    Trebše, Rihard

    2012-01-01

    Infection is becoming the most important as well as the most devastating mechanism of prosthetic joint failure. The incidence is increasing because the absolute number of patients operated is increasing and because more often very sick, debilitated and immunocompromised patients are operated. The trend reveals a further increase in the years to come. Diagnosis may be very easy in case of high grade processes, but also extremely difficult in some other instances. Misdiagnosing infection leads to repeated early failures that are distressing for patients as well as surgeons. To avoid failures related to misdiagnosed prosthetic joint infections a step-wise algorithm of action is proposed and the diagnostic strength of the steps discussed. The key point is to select potential candidates to define the probability of an ongoing infection and then to select the tools to strengthen the suspicion. Further procedures are based on the analysis of the pseudo-synovial fluid obtained by aspiration. Diagnostic conclusions form the basis for treatment decisions. PMID:22956369

  15. Cytologic findings of a clear cell parathyroid lesion.

    PubMed

    Papanicolau-Sengos, Antonios; Brumund, Kevin; Lin, Grace; Hasteh, Farnaz

    2013-08-01

    On fine-needle aspiration (FNA) biopsy, clear cell parathyroid lesions can be misdiagnosed as thyroid neoplasms, salivary gland neoplasms, paraganglioma, or even metastatic renal cell carcinoma. We report the clinicopathological, cytologic, and histologic findings of a clear cell parathyroid tumor in a 64-year-old HIV-positive patient. A computed tomography (CT) scan with contrast showed a heterogeneous and enhancing mass at the inferolateral aspect of the left thyroid lobe. FNA showed a cellular smear with many single and loosely clustered tumor cells with finely granular and vacuolated light-purple cytoplasm and central nuclei. Occasional microfollicular structures were noted. No colloid was seen. This FNA was misdiagnosed as a follicular neoplasm of the thyroid. Sections of the excised mass showed large polyhedral cells with well-defined cell membranes and clear cytoplasm with a small amount of eosinophilic granular material. These clear cells were positive for pancytokeratin and PTH immunohistochemical stains. These results favored a diagnosis of parathyroid Water Clear Cell Adenoma. This brief report highlights the cytologic findings of clear cell parathyroid lesions and their potential diagnostic pitfalls. PMID:22144114

  16. Giant Pulmonary Hydatid Cyst and Trauma in a 9 Year-Old Child: A Case Report

    PubMed Central

    Sokouti, Mohsen; Shokouhi, Behrooz; Sokouti, Massoud; Sokouti, Babak

    2015-01-01

    Herein, we report a case of giant lung hydatid cyst in a nine-year-old boy. For four years, he experienced mild chest pain and chronic nonproductive cough. He had a trauma resulted from a fall two days before admission. Chest X-ray showed misdiagnosed massive pleural effusion, and was aspirated in the other hospital. However, after admission, the computed tomography revealed a giant lung hydatid cyst filling the right hemithorax completely. Being considered by the diagnosis of ruptured lung hydatid cyst, he was treated surgically by right-thoracotomy. The existing hydatid cyst, (e.g., with a dimension of 30*22*20cm) filled all cavity of hemithorax extended from the right diaphragm to the apex of the lung situated in the right lower lobe. After evacuation of the hydatid fluid and laminated membrane, right lower lobectomy was carried out due to remaining no salvageable parenchyma without any complications. Also, the pathologic examination have confirmed hydatid cyst. In conclusion, giant hydatid cysts are probably misdiagnosed with massive pleural effusion in the endemic area. And, because of the risk of allergic reactions, anaphylactic shock and dissemination, it should not be aspirated.

  17. Sclerosing mesenteritis as a rare cause of abdominal pain and intraabdominal mass: a cases report and review of the literature

    PubMed Central

    2008-01-01

    Sclerosing mesenteritis is a rare, benign, and chronic fibrosing inflammation disease with unknown etiology that affects the mesentery of small bowel and colon. The disease has two well-established histological types: the acute or subacute form known as mesenteric panniculitis and the chronic form known as retractile or sclerosing mesenteritis. Because the sclerosing mesenteritis is lack of special clinical manifestation and typical signs, so the patients are very easy to be misdiagnosed. The correct diagnosis of sclerosing mesenteritis depends on pathological examination and exploratory laparotomy. We report a case of sclerosing mesenteritis in a 52-year-old male who presented with chronic abdominal pain and intraabdominal mass. This patient had a long-term and heavy drinking history. He was misdiagnosed as celiac teratoma by CT examination and then underwent an exploratory laparotomy at March 2 2004. A mass, its diameter being about 5 cm, was detected in mesentery of distal ileum. Although a few small intestines tightly adhered on the mass, the involved intestine had no obstruction. The intraoperative biopsy indicated that it was an inflammatory mass. The mass and adhered intestines were removed. He was diagnosed with sclerosing mesenteritis by histopathological examination of paraffin section. After operation, this patient went well and lives without recrudescence at the time we wrote this paper. PMID:18925952

  18. Sclerosing mesenteritis as a rare cause of abdominal pain and intraabdominal mass: a cases report and review of the literature.

    PubMed

    Gu, Guo-Li; Wang, Shi-Lin; Wei, Xue-Ming; Ren, Li; Li, De-Chang; Zou, Fu-Xian

    2008-01-01

    Sclerosing mesenteritis is a rare, benign, and chronic fibrosing inflammation disease with unknown etiology that affects the mesentery of small bowel and colon. The disease has two well-established histological types: the acute or subacute form known as mesenteric panniculitis and the chronic form known as retractile or sclerosing mesenteritis. Because the sclerosing mesenteritis is lack of special clinical manifestation and typical signs, so the patients are very easy to be misdiagnosed. The correct diagnosis of sclerosing mesenteritis depends on pathological examination and exploratory laparotomy. We report a case of sclerosing mesenteritis in a 52-year-old male who presented with chronic abdominal pain and intraabdominal mass. This patient had a long-term and heavy drinking history. He was misdiagnosed as celiac teratoma by CT examination and then underwent an exploratory laparotomy at March 2 2004. A mass, its diameter being about 5 cm, was detected in mesentery of distal ileum. Although a few small intestines tightly adhered on the mass, the involved intestine had no obstruction. The intraoperative biopsy indicated that it was an inflammatory mass. The mass and adhered intestines were removed. He was diagnosed with sclerosing mesenteritis by histopathological examination of paraffin section. After operation, this patient went well and lives without recrudescence at the time we wrote this paper. PMID:18925952

  19. Endoscopic findings and clinicopathologic characteristics of colonic schistosomiasis: A report of 46 cases

    PubMed Central

    Cao, Jun; Liu, Wen-Jia; Xu, Xin-Yun; Zou, Xiao-Ping

    2010-01-01

    AIM: To make a retrospective analysis of endoscopy findings and clinicopathologic characteristics of colonic schistosomiasis in order to further improve our understanding of the disease and decrease its misdiagnosis. METHODS: Endoscopy findings and clinicopathologic characteristics of 46 intestinal schistosomiasis patients were retrospectively analyzed. All the patients underwent colonoscopy and all biopsy specimens stained with hematoxylin and eosin were observed under a light microscope. RESULTS: Of the 46 colonic schistosomiasis patients, 1 was diagnosed as acute schistosomal colitis, 16 as chronic schistosomal colitis and 29 as chronic active schistosomal colitis according to their endoscopic findings and pathology. Not all patients were suspected of or diagnosed as colonic schistosomiasis. Of the 12 misdiagnosed patients, 4 were misdiagnosed as ulcerative colitis, 1 as Crohn’s disease, and 7 as ischemic colitis. The segments of rectum and sigmoid colon were involved in 29 patients (63.0%). Intact Schistosoma ova were deposited in colonic mucosa accompanying infiltration of eosinocytes, lymphocytes, and plasma cells in acute schistosomal colitis patients. Submucosal fibrosis was found in chronic schistosomal colitis patients. Among the 17 patients with a signal polyp, hyperplastic polyp, canalicular adenoma with a low-grade intraepithelial neoplastic change, tubulovillous adenoma with a high-grade intraepithelial neoplastic change were observed in 10, 5, and 2 patients, respectively. Eight out of the 46 patients were diagnosed as colonic carcinoma. CONCLUSION: Endoscopy contributes to the diagnosis of colonic schistosomiasis although it is nonspecific. A correct diagnosis of colonic schistosomiasis can be established by endoscopy in combination with its clinicopathologic characteristics. PMID:20135720

  20. Multicentric epithelioid angiosarcoma of bone.

    PubMed

    Yang, Zhengming; Tao, Huimin; Ye, Zhaoming; Yang, Disheng

    2012-08-01

    Bone epithelioid angiosarcoma is rare and generally shows positive immunostaining for epithelial markers. Multicentric bone epithelioid angiosarcoma is easily misdiagnosed as carcinoma, including metastatic carcinoma, multiple myeloma, and multiple lymphoma of bone. This article describes a case of multicentric bone epithelioid angiosarcoma. The patient was first misdiagnosed as having metastatic carcinoma. Examination showed osteolytic lesions in the bilateral heels and the lower left humerus. The diagnosis was confirmed postoperatively and corrected after immunohistochemical analysis of the biopsy. The immunohistochemical analysis revealed that the tumor mass was strongly positive for CD31, factor VIII, vimentin, and neuron-specific enolase. The patient refused chemotherapy and died of lung metastasis 4 months postoperatively.Most bone epithelioid angiosarcomas are immunopositive for epithelial markers (ie, keratin, cytokeratin, high-molecular-weight keratin, and epithelial membrane antigen), vascular endothelial markers (ie, CD31, CD34, and von Willebrand factor), and factor VIII-associated antigen. Bone epithelioid angiosarcoma shows a relatively high degree of malignancy. Patients often die of distant metastasis, including those found in the lung and lymph node tissue. A wide excision of epithelioid angiosarcoma should be performed during the operation of the primary tumor. A better understanding of the clinicopathologic features of this disease may help to clarify the confusion, provide better treatment, and improve the clinical prognosis. PMID:22868625

  1. Undifferentiated embryonal sarcoma of the liver mistaken for hepatic abscess in an adult

    PubMed Central

    XIE, ZI-YING; LI, LI-PING; WU, WEI-JING; SUN, DA-YONG; ZHOU, MEI-HUA; ZHAO, YA-GANG

    2014-01-01

    Undifferentiated embryonal sarcoma of the liver (UESL) predominantly occurs in children under the age of 10 years, and ~90% of cases occur in children <15 years old. Patients may complain of abdominal pain, fever or other symptoms. No significant decrease has been identified in the hepatic function or elevation of ?-fetoprotein, which differentiates UESL from primary carcinomas of the liver. In the present study, a rare and misdiagnosed case of an UESL arising in a male, which was mistaken for a hepatic abscess and retrospectively re-diagnosed, is reported. This case was misdiagnosed as a hepatic abscess initially, and it was diagnosed as UESL subsequent to performing tests, including a type-B ultrasonic scan and computed tomography (CT), and evaluating pathological findings. The rapid recurrence of the tumor in this patient was identified by CT, and this is associated with the malignancy of the disease. Currently, patients with UESL have a poor prognosis as there is not a successful treatment strategy. The present study analyzes the course of diagnosis and potential treatment for the disease. PMID:25120683

  2. Anterior inferior iliac spine avulsion fracture: a series of 5 cases.

    PubMed

    Serbest, Sancar; Tosun, Hac Bayram; Tiftikçi, U?ur; Oktas, Birhan; Kesgin, Engin

    2015-02-01

    Avulsion fractures of the pelvic apophyses rarely occur in adolescent athletes in the course of sudden strong contraction of muscle attached to growth cartilage. This injury may usually be misdiagnosed for tendon or muscle strain. Patient's history, physical examination, and radiologic studies are important for diagnosis. The literature includes only a few case reports but no case series as yet. The aim of this study was to present the results of 5 cases of anterior inferior iliac spine (AIIS) avulsion fractures treated conservatively. The study included 5 patients (4 male, 1 female, mean age 13.6 years) who underwent conservative treatment for AIIS avulsion fractures and had an adequate follow-up. All patients were admitted to the emergency department and misdiagnosed as muscle strain. Three of them were football player, 1 skier, and 1 fighter. Each patient was treated with immobilization and nonsteroidal anti-inflammatory drugs. At follow-up, all patients showed relief from their pain and mechanical symptoms and regained full range of motion and returned to their previous levels of activity. Diagnosis requires careful attention to the physical examination and imaging. In this series, all pelvic avulsion fractures (100%) were managed successfully with a conservative approach. Good results and return to previous levels of activity can be achieved with conservative treatment. PMID:25700329

  3. Biological risks associated with consumption of reptile products.

    PubMed

    Magnino, Simone; Colin, Pierre; Dei-Cas, Eduardo; Madsen, Mogens; McLauchlin, Jim; Nöckler, Karsten; Maradona, Miguel Prieto; Tsigarida, Eirini; Vanopdenbosch, Emmanuel; Van Peteghem, Carlos

    2009-09-15

    The consumption of a wide variety of species of reptiles caught from the wild has been an important source of protein for humans world-wide for millennia. Terrapins, snakes, lizards, crocodiles and iguanas are now farmed and the consumption and trade of their meat and other edible products have recently increased in some areas of the world. Biological risks associated with the consumption of products from both farmed and wild reptile meat and eggs include infections caused by bacteria (Salmonella spp., Vibrio spp.), parasites (Spirometra, Trichinella, Gnathostoma, pentastomids), as well as intoxications by biotoxins. For crocodiles, Salmonella spp. constitute a significant public health risk due to the high intestinal carrier rate which is reflected in an equally high contamination rate in their fresh and frozen meat. There is a lack of information about the presence of Salmonella spp. in meat from other edible reptilians, though captive reptiles used as pets (lizards or turtles) are frequently carriers of these bacteria in Europe. Parasitic protozoa in reptiles represent a negligible risk for public health compared to parasitic metazoans, of which trichinellosis, pentastomiasis, gnathostomiasis and sparganosis can be acquired through consumption of contaminated crocodile, monitor lizard, turtle and snake meat, respectively. Other reptiles, although found to harbour the above parasites, have not been implicated with their transmission to humans. Freezing treatment inactivates Spirometra and Trichinella in crocodile meat, while the effectiveness of freezing of other reptilian meat is unknown. Biotoxins that accumulate in the flesh of sea turtles may cause chelonitoxism, a type of food poisoning with a high mortality rate in humans. Infections by fungi, including yeasts, and viruses widely occur in reptiles but have not been linked to a human health risk through the contamination of their meat. Currently there are no indications that natural transmissible spongiform encephalopathies (TSEs) occur in reptilians. The feeding of farmed reptiles with non-processed and recycled animal products is likely to increase the occurrence of biological hazards in reptile meat. Application of GHP, GMP and HACCP procedures, respectively at farm and slaughterhouse level, is crucial for controlling the hazards. PMID:19679367

  4. Seropositive Neuromyelitis Optica imitating an Intramedullary Cervical Spinal Cord Tumor: Case Report and Brief Review of the Literature

    PubMed Central

    Chiu, Jennifer Hiu-Fung; Leung, Kar-Ming; Chan, Kwong-Yau

    2014-01-01

    A 44-year-old woman with progressive cervical myelopathy and central cord syndrome was noted to have an extensive cervical intramedullary contrast-enhancing lesion on magnetic resonance imaging (MRI). The lesion resembled a spinal astrocytoma or ependymoma that required surgical intervention. She was subsequently diagnosed to have neuromyelitis optica (NMO), a rare idiopathic inflammatory demyelinating disorder, when the clinical examination revealed left optic atrophy. This was confirmed by a test showing seropositivity for NMO-immunoglobulin (IgG). Disease control was achieved with corticosteroids and immunosuppressive therapy. We report a rare case of a patient with NMO who had MRI features that could have easily led to the condition being misdiagnosed as a spinal cord tumor. The importance of careful history taking, awareness of typical radiological findings and the usefulness of serum NMO-IgG as a diagnostic tool are emphasized. PMID:25346824

  5. Nightmares that mislead to diagnosis of reactivation of PTSD

    PubMed Central

    Roepke, Stefan; Hansen, Marie-Luise; Peter, Anita; Merkl, Angela; Palafox, Carla; Danker-Hopfe, Heidi

    2013-01-01

    Background Sleep disturbance is a common characteristic of patients with post-traumatic stress disorder (PTSD). Besides the clinical descriptions of nightmares and insomnia, periodic limb movements (PLMs) are reported to co-occur in PTSD. Although the causal relationship between sleep disturbance and PTSD is not fully understood, sleep disturbance is an independent risk factor for the development and reactivation of PTSD. In contrast, the link between PTSD and REM sleep behaviour disorder (RBD) is less clear. Method A case report is presented to illustrate differential diagnosis and time course of sleep disturbance in the context of PTSD. Result A 63-year-old man who had been successfully treated for PTSD but who suffered the re-occurrence of disturbed sleep due to RBD and PLM, which was misdiagnosed as reactivation of PTSD. Conclusions RBD can mimic PTSD-related nightmares. Accurate diagnosis of sleep disturbance in PTSD is relevant for treatment and prognostic evaluation. PMID:23556065

  6. Pediatric Stroke: A Review

    PubMed Central

    Tsze, Daniel S.; Valente, Jonathan H.

    2011-01-01

    Stroke is relatively rare in children, but can lead to significant morbidity and mortality. Understanding that children with strokes present differently than adults and often present with unique risk factors will optimize outcomes in children. Despite an increased incidence of pediatric stroke, there is often a delay in diagnosis, and cases may still remain under- or misdiagnosed. Clinical presentation will vary based on the child's age, and children will have risk factors for stroke that are less common than in adults. Management strategies in children are extrapolated primarily from adult studies, but with different considerations regarding short-term anticoagulation and guarded recommendations regarding thrombolytics. Although most recommendations for management are extrapolated from adult populations, they still remain useful, in conjunction with pediatric-specific considerations. PMID:22254140

  7. Transient epileptic amnesia in a memory clinic setting: a report of three cases.

    PubMed

    Ioannidis, P; Balamoutsos, G; Karabela, O; Kosmidis, M H; Karacostas, D

    2011-02-01

    Transient epileptic amnesia (TEA) is a recently described, typically misdiagnosed at presentation, distinctive syndrome, characterized by recurrent, brief attacks of memory loss in middle-aged or elderly people, accompanied by significant interictal memory difficulties. We describe the clinical, neuroimaging, electrophysiological, and neuropsychological characteristics of three patients fulfilling the proposed criteria for TEA, initially referred to our memory clinic for evaluation and treatment of probable dementia. Neuropsychological performance on admission and 6 months after treatment demonstrated a broad range of performance on measures of executive function, lower than expected visuospatial perception, and poor autobiographical memory. TEA should be included in the differential diagnosis of dementia to avoid misdiagnosis and needless medication. It is a benign and treatable condition, yet the associated decline in autobiographical and remote memory despite antiepileptic therapy poses challenges for further research. PMID:21273136

  8. Radiologist's perspective for the Meckel's diverticulum and its complications.

    PubMed

    Kotha, V K; Khandelwal, A; Saboo, S S; Shanbhogue, A K P; Virmani, V; Marginean, E C; Menias, C O

    2014-05-01

    The Meckel's diverticulum is the commonest congenital anomaly of the gastrointestinal tract, often presenting with complications such as gastrointestinal bleeding, intussusception, bowel obstruction and diverticulitis, which are often misdiagnosed. Imaging plays an important role in the early diagnosis and characterization of these conditions and is very helpful in decision making. The Meckel's diverticulum and its complications have myriad presentations and appearances on various imaging modalities. Thus, sound knowledge of the anatomy, embryology, clinical presentation, imaging characteristics and complications is crucial to the practice of abdominal imaging. We present a review of the literature and current radiological practices in the diagnosis and management of the Meckel's diverticulum and its various complications with special emphasis on the imaging of various complications, mimickers and pathological correlation. PMID:24611767

  9. Radiologist's perspective for the Meckel's diverticulum and its complications

    PubMed Central

    Kotha, V K; Saboo, S S; Shanbhogue, A K P; Virmani, V; Marginean, E C; Menias, C O

    2014-01-01

    The Meckel's diverticulum is the commonest congenital anomaly of the gastrointestinal tract, often presenting with complications such as gastrointestinal bleeding, intussusception, bowel obstruction and diverticulitis, which are often misdiagnosed. Imaging plays an important role in the early diagnosis and characterization of these conditions and is very helpful in decision making. The Meckel's diverticulum and its complications have myriad presentations and appearances on various imaging modalities. Thus, sound knowledge of the anatomy, embryology, clinical presentation, imaging characteristics and complications is crucial to the practice of abdominal imaging. We present a review of the literature and current radiological practices in the diagnosis and management of the Meckel's diverticulum and its various complications with special emphasis on the imaging of various complications, mimickers and pathological correlation. PMID:24611767

  10. Tinea capitis caused by Trichophyton tonsurans presenting as an obscure patchy hair loss due to daily antifungal shampoo use

    PubMed Central

    Sombatmaithai, Alita; Pattanaprichakul, Penvadee; Tuchinda, Papapit; Surawan, Theetat; Muanprasart, Chanai; Matthapan, Lalita; Bunyaratavej, Sumanas

    2015-01-01

    Tinea capitis is unusual and often misdiagnosed in healthy adults. We report a case of a healthy woman with a several-year history of asymptomatic, bizarre-shaped, non-scarring alopecia. She had used over-the-counter ketoconazole shampoo regularly for a long time. An initial potassium hydroxide preparation showed negative result for fungal organism. The scalp biopsy revealed endothrix infection, and dermoscopic examination demonstrated the comma hair and corkscrew hair signs. The fungal culture showed Trichophyton tonsurans. The daily use of antifungal shampoo could be the important factor to conceal clinical and laboratory findings for diagnosis of T. tonsurans tinea capitis in our case, which required high clinical suspicion and histopathology and dermoscopic examinations. PMID:26114071

  11. Psychogenic non-epileptic seizures in the older adult.

    PubMed

    Yates, Erica

    2014-05-01

    Psychogenic non-epileptic seizures (PNES) are classified in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, as a functional neurological symptom disorder. This disorder is often misdiagnosed as epilepsy, with the consequence that older adults may have been treated for years for epilepsy before they learn their seizures are non-epileptic. Video electroencephalography monitoring, which is the standardized approach for ruling out epilepsy, is often performed in a specialized epilepsy monitoring unit where the patient lies in bed 24 hours per day waiting for a seizure to be recorded. The immobility, loss of independence, and anxiety that occurs during the monitoring process can be difficult for older adults. It is important for all nurses to be aware of PNES and to be sensitive to the unique needs of older adults who are experiencing these seizures. PMID:24815758

  12. Secondary glaucoma as initial manifestation of ring melanoma: a case report and review of literature

    PubMed Central

    Zhao, Manli; Mu, Yalin; Dang, Yalong; Zhu, Yu

    2014-01-01

    Melanomas account for over 70% of adult malignancies in the eye and occur primarily in the choroid. Melanomas rarely originate in the ciliary body, with an annual incidence of approximately 1.6 cases per million. While the incidence rate of these tumors is low, malignant melanomas metastasize at early stages of disease development and show poor prognoses. Malignant melanomas of the ciliary body are often deeply hidden and have complex clinical manifestations, which are easily misdiagnosed and affect the prognosis. Here, we report a case of monocular ciliary body melanoma in an elderly Asian woman. Using this case as an example, we perform a systematic review of the disease’s clinical symptoms, signs, diagnoses, differential diagnoses, treatment and prognosis. PMID:25550867

  13. Nodular fasciitis of the lip mucosa: a rare but clinically important entity.

    PubMed

    Lloyd, A A; Witheiler, D; Menter, A

    2015-06-01

    Oral nodular fasciitis (NF) is a rare benign entity of significant clinical importance, which presents as a rapidly growing soft tissue mass. Awareness of this entity is essential, because histologically it resembles a malignancy at first glance, owing to its spindled histological nature and numerous typical mitoses. Thus, it is often misdiagnosed as an aggressive sarcoma, resulting in unnecessary radical surgery. In total, 45 cases of oral NF have been reported since 1966, of which only 2 were reported in the dermatological literature. Patients with NF of the lip mucosa will frequently present to a dermatologist. Therefore, it is critical that dermatologists recognize this benign neoplasm to correctly manage it and avoid potentially catastrophic unnecessary surgery, as these lesions typically spontaneously resolve. We describe the clinical, histological and immunohistochemistry findings of NF in a 51-year-old woman, and discuss its differential diagnosis. PMID:25623839

  14. Giant epidermal cyst in the posterior neck developing over 40 years: A case report.

    PubMed

    Park, Tae Won; Kim, Jong Kil; Kim, Jung Ryul

    2014-01-01

    Conventional epidermal cysts are generally small, slow-growing, non-tender, dome-shaped lesions. An epidermal cyst is usually asymptomatic until it is infected or enlarged to the extent that it causes damage to adjacent anatomical structures. However, few cases of giant epidermal cysts in the neck have been reported. The present case reports a giant epidermal cyst in the posterior neck, which grew to an extremely large size for >40 years without inflammation or rupture, and was misdiagnosed as a large soft tissue neoplasm. The patient exhibited depression and developed social anxiety due to the negative cosmetic consequences of the large mass. The patient underwent excision of the mass. At the follow-up examination two years postoperatively, there were no local recurrence and the psychiatric symptoms of the patient were completely resolved. To the best of our knowledge, a giant epidermal cyst growing for >40 years has not previously been reported. PMID:24348807

  15. [Efficacy of dermoplasty and the dermal equivalent in treatment of vast leg ulcers of mixed genesis].

    PubMed

    Andreev, D Iu; Abramova, N V; Blinova, M I; Pinaev, G P

    2013-01-01

    The most frequent causes of leg ulcers (90-95%) are chronic venous insufficiency (45-60%), obliterating atherosclerosis of the lower extremity arteries (10-20%), diabetes mellitus (15-25%) and their combinations (10-15%). The leg ulcers, specified as pyoderma gangrenosum, are the rare and severe pathology, which is very often misdiagnosed. The case history of a 58-year old female patient with vast leg ulcers of the both shanks is analyzed. The leg ulcers were caused by pyoderma gangrenosum and chronic venous insufficiency due to the varicose disease. Complete epithelization of both ulcers was achieved by means of dermoplasty combined using the dermal equivalent against the background of system immunosuppressive therapy. PMID:23808240

  16. Thoracic manifestations of paradoxical immune reconstitution inflammatory syndrome during or after antituberculous therapy in HIV-negative patients

    PubMed Central

    Pornsuriyasak, Prapaporn; Suwatanapongched, Thitiporn

    2015-01-01

    Immune reconstitution inflammatory syndrome (IRIS) is a consequence of exaggerated and dysregulated host’s inflammatory response to invading microorganism, leading to uncontrolled inflammatory reactions. IRIS associated with tuberculosis (TB) is well recognized among human immunodeficiency virus (HIV)-infected patients receiving highly active antiretroviral therapy, but it is less common among HIV-negative patients. IRIS can manifest as a paradoxical worsening or recurring of preexisting tuberculous lesions or development of new lesions despite successful antituberculous treatment. Hence, the condition might be misdiagnosed as superimposed infections, treatment failure, or relapse of TB. This pictorial essay reviewed diagnostic criteria and various thoracic manifestations of the paradoxical form of TB-associated IRIS (TB-IRIS) that might aid in early recognition of this clinical entity among HIV-negative patients. The treatment and outcomes of TB-IRIS were also discussed. PMID:25698091

  17. “Reverse McConnell’s Sign”: Interpreting Interventricular Hemodynamic Dependency and Guiding the Management of Acute Heart Failure during Takotsubo Cardiomyopathy

    PubMed Central

    Liu, Kan; Sun, Zhongxia; Wei, Tiemin

    2015-01-01

    Although most patients with Takotsubo cardiomyopathy (TTC) have benign clinical course and prognosis, TTC can induce acute heart failure and hemodynamic instability. TTC mimics the clinical features of acute anterior wall myocardial infarction (AMI). Bedside clinicians often have a diagnostic dilemma when cardiac catheterization and angiography are either contraindicated or can cause potential adverse consequences. Misdiagnosing TTC as AMI will lead to initiation of harmful pharmacological or device-based treatment, which worsens hemodynamic compromise. Therefore, understanding and interpreting the unique pathophysiological and hemodynamic features of TTC in a better manner becomes crucial to guide effective clinical management of acute heart failure/cardiogenic shock during TTC. We review recent advances in echocardiographic diagnosis of TTC and its role in guiding bedside management of acute heart failure and cardiogenic shock, with specific focus on the interpretation of discrepant, but reciprocally dependent, left and right ventricular hemodynamics during acute stages of TTC. PMID:25861229

  18. Recognition and treatment of neurologic Wilson's disease.

    PubMed

    Lorincz, Matthew T

    2012-11-01

    As Wilson's disease is both preventable and treatable, the diagnosis must not be missed. Despite this, it is usually misdiagnosed. Misdiagnosis and delay in treatment are clinically relevant because if left untreated, Wilson's disease progresses to hepatic failure or severe neurologic disability, and death. Those adequately treated have a normal life span. Wilson's disease is an autosomal recessive disease caused by mutations in the ATP7B gene. Mutations in ATP7B result in abnormal copper metabolism and subsequent toxic accumulation of copper. The clinical manifestations of neurologic Wilson's disease include variable combinations of dysarthria, dystonia, tremor, parkinsonism, ataxia, and choreoathetosis. Once the possibility of Wilson's disease is considered, diagnosis is straight forward. Currently available treatments, including zinc acetate and trientine, are generally well tolerated and effective. PMID:23677665

  19. MR Imaging Findings in Alcoholic and Nonalcoholic Acute Wernicke's Encephalopathy: A Review

    PubMed Central

    Manzo, Gaetana; De Gennaro, Angela; Cozzolino, Attilio; Serino, Antonietta; Fenza, Giacomo; Manto, Andrea

    2014-01-01

    Wernicke's encephalopathy (WE) is a severe neurological syndrome caused by thiamine (vitamin B1) deficiency and clinically characterized by the sudden onset of mental status changes, ocular abnormalities, and ataxia. Apart from chronic alcoholism, the most common cause of WE, a lot of other conditions causing malnutrition and decreasing thiamine absorption such as gastrointestinal surgical procedures and hyperemesis gravidarum must be considered as predisposing factors. Due to its low prevalence and clinical heterogeneity, WE is often misdiagnosed, leading to persistent dysfunctions and, in some cases, to death. Nowadays, MR imaging of the brain, showing T2 and FLAIR hyperintensities in typical (thalami, mammillary bodies, tectal plate, and periaqueductal area) and atypical areas (cerebellum, cranial nerve nuclei, and cerebral cortex), is surely the most important and effective tool in the diagnostic assessment of WE. The aim of this paper is to propose a state of the art of the role of MR imaging in the early diagnosis of this complex disease. PMID:25050351

  20. Advanced clinical interpretation of the WAIS-IV and WMS-IV: prevalence of low scores varies by level of intelligence and years of education.

    PubMed

    Brooks, Brian L; Holdnack, James A; Iverson, Grant L

    2011-06-01

    Clinicians can use the base rates of low scores in healthy people to reduce the likelihood of misdiagnosing cognitive impairment. In the present study, base rates were developed for the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) and Wechsler Memory Scale-Fourth Edition (WMS-IV) using 900 healthy adults and validated on 28 patients with moderate or severe traumatic brain injuries (TBIs). Results indicated that healthy people obtain some low scores on the WAIS-IV/WMS-IV, with prevalence rates increasing with fewer years of education and lower predicted intelligence. When applying the base rates information to the clinical sample, the TBI patients were 13 times more likely to be identified as having a low cognitive profile compared with the controls. Using the base rates information is a psychometrically advanced method for establishing criteria to determine low cognitive abilities on the WAIS-IV/WMS-IV. PMID:20947705